We are seeking a dedicated Billing and Collections Representative to join our team. In this role, you will be responsible for managing collections, account follow-up, and billing allowance posting for assigned accounts. Your primary focus will be ensuring timely resolution of outstanding claims by interacting with payers via phone, email, fax, or websites.
Responsibilities
Follow up with payers to ensure timely resolution of outstanding claims.
Utilize various workflow systems and client host systems (e.g., STAR, SMS, EAGLE, EPIC) and other tools to collect payments and resolve accounts.
Demonstrate a working knowledge of the insurance follow-up process and healthcare reimbursement methodologies.
Understand government, Medicare, and Medicaid claims processes.
Review and update patient and financial information accurately.
Verify accuracy of information related to responsible parties for bill payment.
Monitor billing accuracy and update records as necessary.
Monitor Medicaid/healthy options coupons to ensure timely billing of services.
Ensure correct billing of hospital services to primary insurers or patients within expected timeframes.
Explain hospital and insurance regulations regarding account payment methods.
Identify and report underpayments and denial trends.
Analyze and resolve issues causing payer payment delays; initiate appeals when necessary.
Possess basic knowledge of healthcare claims processing, including ICD-9/10, CPT, HCPC codes, and UB-04.
Use Excel to manipulate spreadsheets and effectively communicate results.
Meet daily productivity and quality standards as per departmental policies.
Act professionally and courteously with patients, insurance payors, colleagues, management, and clients.
Perform special projects and other duties as assigned.
Maintain strict confidentiality of patient health information as per HIPAA standards.
Qualifications
Previous experience in hospital/facility billing required.
2-3 years' experience in insurance collections, including claims submission and follow-up.
Ability to work independently and collaboratively in a team environment.
Proficiency in Microsoft Office, including Excel and Word.
Strong organizational, communication, and written skills.
Basic math and typing proficiency.
High School Diploma required; Medical Billing and Coding certification preferred.
Employment Type: Full-Time
Seniority level
Entry level
Employment type
Full-time
Job function
Health Care Provider
Industries
Human Resources Services
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