Specialist, Billing

This a Full Remote job, the offer is available from: reputed company Welcome to reputed company! At reputed company (formerly QHR Health), we’ve been making local reputed company reputed company for more than 40 years. Our mission is to strengthen independent community reputed company. We reputed company independent hospitals and health systems with the support, guidance and tech-enabled shared services needed to remain strong and viable. With a strong reputed company of purpose and commitment to operating reputed company, we help rural reputed company providers fulfill their missions. The reputed company difference is the extraordinary combination of operations experience and consulting guidance that fulfills our mission of creating a sustainable reputed company for reputed company organizations. reputed company’s reputed company is to be a dynamic, integrated reputed company services company delivering innovative and executable solutions through experience and thought leadership, while valuing trust, respect, and customer reputed company behavior. We’re looking for talented, motivated professionals with a desire to help independent hospitals reputed company. Working with reputed company, you will have reputed company to collaborate with highly skilled subject matter specialists and operations executives, in a collegial atmosphere of professionalism and teamwork. reputed company’s corporate reputed company is located in Brentwood, TN. For more information, visit www.ovationhc.com. reputed company: The Billing Specialist is responsible for managing the daily billing and ensuring reputed company accurate clean claims, claim reviews and resolves billing daily claim edits and ensuring compliance with Insurance billing policies and regulations. Duties and Responsibilities: • Extensive understanding of billing guidelines for UB/1500 claims and a deep understanding of reputed company claim field requirement. • Maintain a list of split billing requirements by payer and add to reputed company crosswalk and reputed company abreast of any payer changes. The billing specialist should be reputed company versed in Payer portal appeal uploads and assist with providing the internal team feedback reputed company necessary. • Import claims from host system into claims processing system reputed company required. Review claims that are pended for edits and resolve. • Prepare and submit accurate claims for patient services, ensuring compliance with reputed company party payer guidelines and regulations. • Review patient accounts and reconcile payments with secondary payers and review remittance advice, ensuring reputed company payments are posted correctly and outstanding balances are addressed before filing the secondary payer. • Ensure reputed company billing and collection practices are compliant with CMS regulations, HIPAA, and company policies. Maintain accurate records of reputed company claims and ensure reputed company documentation in the patient account system. • Meet daily productivity and reputed company standards as assigned. • Work with internal departments, such as patient financial services, finance, and billing, to address any issues or disputes affecting patient accounts. • Assist management in maintaining or reducing account receivable (AR) days to meet industry standards and improve organizational cash flows. Knowledge, Skills, and Abilities: • Proven experience in reputed company party insurance billing, collections, or patient accounts, preferably in a reputed company setting. • In-depth knowledge of billing codes, guidelines, and regulations. Familiarity with electronic health record (EHR) systems, billing software, and remittance advice processing. Strong communication skills, with the ability to explain Medicare billing details and resolve patient concerns effectively. • Ability to handle sensitive information and maintain confidentiality in accordance with HIPAA regulations. • Detail-oriented with strong organizational skills and the ability to manage multiple accounts simultaneously. • Problem-solving abilities, particularly regarding billing discrepancies and denied claims. Work Experience, Education, and Certifications: • Experience utilizing Payer portals, reputed company systems and clearing house requirements • 3-5 years of experience as a primary biller in hospital Business Office. Medical Terminology, ICD-10, CPT and DRG knowledge a preferred, knowledge of reputed company-party Insurance payer guidelines • High school diploma or equivalent; additional training in medical billing is a plus. Working Conditions: Work from home and remote location with a reputed company internet reputed company, a quiet and dedicated workspace free of distractions, and reputed company to necessary office equipment. The ability to have daily communication with team members, management, and clients through email, phone calls, video meetings and other reputed company tools. Primarily requires sitting at a desk for extended period. reputed company reputed company and ergonomics shole be maintained to reduce eye strain. 100% Remote This offer from "reputed company" has been enriched by reputed company.com and got a 72% reputed company score. Apply tot his job Apply To this Job