Billing Representative

Penn Medicine is dedicated to our tripartite mission of providing the highest level of care to patients, conducting innovative research, and educating future leaders in the field of medicine. Working for this leading academic medical center means collaboration with top clinical, technical and business professionals across all disciplines.

Today at Penn Medicine, someone will make a breakthrough. Someone will heal a heart, deliver hopeful news, and give comfort and reassurance. Our employees shape our future each day. Are you living your life's work?

Summary:

• Assist in the financial and administrative operations of the Physician Billing Program. Assist in all phases of the revenue cycle for Physician Billing including charge entry, payment posting, accounts receivable follow up, and payer communication and education. Will utilize daily system reports to identify unpaid claims, contact payers, and follow payer regulations to rebill or send additional information.

Responsibilities:

• 1. Ongoing support and analysis of routine financial functions of the department, including billing, Accounts receivable, aging reports, and productivity. Assures consistent quality and cost effectiveness of daily operations through coordination with physicians, patients and process assessment 2. Responsible for accuracy of all submitted charges for physicians on a daily basis. Post provider services utilizing CPT, HCPCS, ICD9/10, with applicable modifiers. 3. Ongoing financial support and analysis of reimbursement issues and insurance contracts. Assures compliance with payer and Regulatory agencies. Develop an understanding of Medicare, Medicaid, intermediary and 3rd party pay rules and regulations as applied to Provider services to facilitate account resolution Receives, identifies and applies payments from all sources to patient accounts. Researches and resolves over/under payments from all sources. • a. Receives, identifies and applies payments from all sources on a daily basis. • b. Researches, initiates and posts refunds when required. Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency. 4. Enter insurance data, prepare and submit claims to all insurance companies and patients, receive remittance lists from insurance companies, identify payments and denials, apply payments to patient records for all sources, and investigate and follow up on denied claims. Enters insurance information to patient accounts for billing of fees for Physician Billing Programs. • a. Enters insurance information as required, as evidenced in remittance lists from Insurance companies or patient payment. Prepares, submits, and follows up bills to all payors. Prepares, submits bills and follows up self pay accounts for non-covered services, denials and co-payments. • a. Bills all payors within scheduled time frame in accordance with insurance regulations and requirements. Resolves all open balances. • b. Processes claim rejections as received. Researches exceptions, problems, Incorrect data/information, and open balances. • c. Bills patients' accounts for non-covered services and co-payments and follows up as required, via telephone calls or written correspondence, as documented on patients' records. • d. Ensures accurate and timely communication of medical reports to primary and or referring physicians in established time frame. Create billing error reports and check for accuracy, correct all errors for billing. Receives, identifies and applies payments from all sources to patient accounts. Researches and resolves over/under payments from all sources. • a. Receives, identifies and applies payments from all sources on a daily basis. • b. Researches, initiates and posts refunds when required. Coordinates with hospital cashier, cash being posted to physician billing programs. Recommends patient accounts for write-offs, health assistance, or referral to outside Collection agency. 5. Provides education and feedback to front end operations 6. Assists in Facilitating Office Communication, Guest/Human Relations Coordinates and maintains positive communications including correspondence, phone call from patients and insurance carriers. Enhances professional growth and development and assumes accountability for performance effectiveness.

Credentials:


Education or Equivalent Experience:

• H.S. Diploma/GED (Required)
• Expertise in reimbursement analysis. Familiarity with computer data entry, coding, and billing procedures. Work experience in healthcare, Work experience in healthcare, preferably in a medical office setting

We believe that the best care for our patients starts with the best care for our employees. Our employee benefits programs help our employees get healthy and stay healthy. We offer a comprehensive compensation and benefits program that includes one of the finest prepaid tuition assistance programs in the region. Penn Medicine employees are actively engaged and committed to our mission. Together we will continue to make medical advances that help people live longer, healthier lives.

Live Your Life's Work

We are an Equal Opportunity employer. Candidates are considered for employment without regard to race, ethnicity, color, sex, sexual orientation, gender identity, religion, national origin, ancestry, age, disability, marital status, familial status, genetic information, domestic or sexual violence victim status, citizenship status, military status, status as a protected veteran or any other status protected by applicable law.