Billing Specialist I – PB Medical Billing

Job Description:

• Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
• Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers.
• Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
• Respond timely to emails and telephone messages as appropriate.
• Communicate issues to management, including payer, system or escalated account issues.
• Participate and attend meetings as requested, training seminars and in-services to develop job knowledge.
• Serve and protect the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
• Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
• Update patient demographics/insurance information in appropriate systems - Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
• Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
• Secure needed medical documentation required or requested by third party insurance carriers.
• Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.
• Perform other related duties as required.

Requirements:

• 1-2 years of medical collections/billing experience
• Basic knowledge of ICD-10, CPT, HCPCS and NCCI
• Basic knowledge of third-party billing guidelines
• Basic knowledge of billing claim forms (UB04/1500)
• Basic knowledge of payor contracts
• Working Knowledge of Microsoft Word and Excel
• Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
• Preferred Qualifications Working knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
• Working knowledge of DDE Medicare claim system

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