Hospital Biller Service Representative
- Req ID: req4383
- City, State: Piscataway, NJ
- Department: Business Office
- Job Type: On-Site
- Job Schedule: Full-Time
Hospital Biller Service Representative
Business Office
The Hospital Biller Service Representative will:
Requirements:
Schedule: Full Time, Mon-Fri, 8 am or 8:30 am shift, after 90 days - Hybrid Schedule
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Business Office
The Hospital Biller Service Representative will:
- Ensure account accuracy.
- Review daily claims to ensure submissions are clean and timely.
- Monitor charges/modifiers/CPT-4s/HCPCS/payments/DRGs/ICD-10 coding.
- Review outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances.
- Submit timely and accurate adjustments/notes/patient balance transfers and medical record requests.
- Work with management team and notifying of notifying of issues that arise with payors/departments/etc
- Resolve account issues and problem solving independently whenever possible.
- Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.)
- Manage denials and appealing administrative claims.
- Understand denials and how they should be handled.
- Send clinical denials and downgraded claims to appropriate parties to ensure timely appeal.
- Ensure claims denied at time of billing are distributed to appropriate parties for review.
- Update and correct accounts with assistance of originating departments (charges/authorizations/insurance issues).
- Follow departmental and hospital policy and procedure (this includes HIPAA guidelines and Federal guidelines).
- Understand payor contracts and billing guidelines; revenue codes and payor specific requirements; and payor/plan codes.
Requirements:
- Requires one (1)or more years experience as a Medical Insurance Biller or related responsibilities and Hospital Billing strongly preferred.
- Proficient in Microsoft Word and Microsoft Excel.
- Requires high level of interpersonal skills necessary to lead others and to work effectively with Patient Accounts Personnel as well as outside agencies.
- Must possess a comprehensive knowledge of Collection, A/R follow-up and Billing. Knowledge of third-party payers, State and Federal Agencies (constantly changing) with regards to Patient Accounting.
- Requires the ability to consistently meet deadlines, to concentrate and pay attention to details 75% of work time.
Schedule: Full Time, Mon-Fri, 8 am or 8:30 am shift, after 90 days - Hybrid Schedule
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