BILLING REPRESENTATIVE

Job Details Location: OneCore Health - Oklahoma City, OK 73114 Position Type: Full Time Responsibilities Perform all data entry functions necessary for accurate and timely daily processing. This will include but is not limited to the following: perform complete chart reviews, verify patient demographics, assign modifiers, diagnosis codes, and revenue codes in accordance with coding and reimbursement guidelines resulting in claim reimbursement. Maintains and tracks all scheduled cases for accurate billing. Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry. Capture implants, high-cost supplies, high-cost drugs, post-op pain blocks and observation times prior to charge submission. Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc. Execute the recurring billing workflow and generate and transmit claims daily for primary, secondary and tertiary balances. Ensure timely follow-up and resolution of internal and external inquiries of billing issues (e.g., operative notes, invoices, or implant pricing etc.). Reconcile revenue and billing during the period-end close process. Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily. Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer. Refer difficulties or problems involving billing and collection efforts immediately to the Manager. Monitor accuracy, timeliness and completeness of patient accounts, including demographic, insurance, referral and pre-certification information. Maintain complete and accurate files of all insurance information and contracts. Keep abreast of insurance changes and requirements. Ensure that up-to-date carrier information is maintained in the computer. Help maintain patient confidentiality standards for both medical and financial information. Maintain current knowledge of health care billing laws, rules and regulations and developments. Participate in all compliance programs. Participate in loss prevention by protecting company assets and maintaining a safe environment. Perform other related duties incidental to the work required in this job description. Qualifications Education and Skills: High school diploma or equivalent required. Good interpersonal skills, excellent telephone etiquette, good verbal and written communication skills. Ability to read and interpret insurance explanations of benefits and managed-care contracts. Experience: At least one year experience in billing/patient account management in a healthcare setting preferred. Proven knowledge of Medicare Compliance billing guide, Medicare/Medicaid and Managed Care contracts preferred. Knowledge of global and bundling coding guidelines preferred. Intermediate computer proficiency in Microsoft Office including Excel and Outlook. #J-18808-Ljbffr Hospital For Special Surgery