Responsible for billing, electronic claims submission, follow up and collections of patient accounts.
High school diploma, General Educational Development (GED) or equivalent required
Coursework in Coding, Billing or Healthcare Management normally acquired through enrollment in a secondary education institution or online classes through the American Heath Information Management Association (AHIMA) preferred.
Minimum of one (1) year prior experience in healthcare third party billing and/or claims processing preferred.
Prior exposure to UP04 and/or CMS1500 claim data normally acquired through work in a physician’s office or other healthcare setting preferred.
Skill in interpreting UB04 and/or CMS1500 claim data to be able to troubleshoot claim edits and resolve payer billing requirements both timely and accurately.
Ability to create and submit both original and corrected claims.
Ability to audit accounts and payer explanation of benefits (EOBs) to determine appropriate action.
Ability to use effective communication skills in order to handle patient inquires, attorneys, health system staff and payers on a professional level.
Knowledge and understanding of accounting and business principles to enable accurate auditing of patient accounts.
Ability to follow up with the 3rd party payers for claims and appeals submitted to ensure timely and accurate processing.
Ability to maintain a working knowledge of multiple system applications.
Light Work - Exerting up to 20 pounds of force.
Occasionally Performed (1%-33%):
Frequently Performed (34%-66%):
Constantly Performed (67%-100%):
Biological agents (primary air born and blood born viruses) (Jobs with Patient contact) (BBF)