We are seeking a dedicated and detail-oriented Hospital/Physician Biller to join the healthcare team. The ideal candidate will possess a comprehensive understanding of medical coding and billing processes, with expertise in various coding systems such as DRG (Diagnosis-Related Group), CPT (Current Procedural Terminology), ICD-9, and ICD-10. This role is crucial in ensuring accurate medical record management and compliance with healthcare regulations while contributing to the overall efficiency of hospital operations.
Responsibilities
* Maintains responsibility for the timely submission of all hospital and physician claims
* Works daily electronic billing files and submits insurance claims to third-party payers; reviews daily edit reports from the hospital billing system and makes necessary corrections to allow electronic submission.
* Reviews error reports from electronic payers; identifies errors and makes appropriate corrections to ensure accurate claim submission.
* Prepares and submits manual insurance claims to third-party payers who do not accept electronic claims or who require special handling.
* Documents activity on the patient account, ensuring hospital compliance with all state and federal billing regulations, and reports any suspected compliance issues to the Billing Manager and/or Supervisor.
* Works denials in Practice Plus, Thrive, Trubridge, and TriZetto to ensure claims are processed timely.
* Index scanned documents for the department
* Assist with other revenue cycle duties as needed
* Acts in accordance with mission and values, while serving as a role model for ethical behavior
* Adheres to federal and state regulations related to the protection of patient information (e.g., the Health Insurance Portability and Accountability Act (HIPAA) as well as facility-specific guidelines
* Other duties as assigned
Requirements
* Coding Certification (CPC, CCS, CCA, COC, CBCS or CRC from AHIMA or AAPC) preferred
* Minimum two years' experience in a healthcare environment, particularly in healthcare billing, collections, payment processing, or denial management.
* Strong attention to detail and problem-solving
* Experience working with the Electronic medical records
* Familiar with insurance claims and appeal process
* Excellent communication and interpersonal skills
* Able to work independently and manage a high volume of claims and tasks
* Familiarity with EMR and EHR systems for efficient management of patient records.
* Join us in delivering exceptional healthcare services through precise medical coding practices that support our commitment to quality patient care!
If you possess all of the above skills, please apply now.