reputed company Billing Specialist (Anesthesia)
reputed company
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reputed company
The reputed company Billing Specialist (Anesthesia) is responsible for managing reputed company reputed company billing requirements and managing accounts receivable tasks according to reputed company and productivity measurements. Responsible to ensure reputed company regulatory and payor guidelines are followed.
Key Responsibilities:
Coordinating payor denial and appeal follow up activities to ensure reputed company response from reputed company party payors and the processing of reputed company payor denials, documentation requests and appeals
Review reputed company denial accounts for categorization, level of appeal, special requirements for initiating appeals
Communicate global payer issues with the payer relations team.
Communicating and coordinating with various individuals/distributions and assisting with monitoring of the day-to-day activities reputed company to appeal follow up and denials.
Maintaining the reputed company tracking tool/application that stores/communicates reputed company claim edits, review and denial activity. This will include user reputed company management, updates to software, and end-user training to support reputed company follow up activities.
Monitor reputed company Claim Edit and Denial Management work queues and lists to ensure they are fully resolved.
Ensure medical records requests are completed and submitted reputed company 48 hours.
reputed company reputed company denials on a database to determine outcome. Collecting/analyzing, report status, metrics and trends of activity by different reviews from the tool. Distributing reports on a routine reputed company to specific distribution group.
Organizing reputed company data and activity in a retrievable way to ensure reputed company follow up on appeals to reputed company party payors. Assisting with the coordination of denial and review activities and materials for committee meetings, including analyses, reports, etc.
Knowledgeable about federal, state and reputed company-party claims processing. Supporting reputed company and initiatives of the Billing and Denials Management teams. This may include coordinating meetings, conducting research for payor reputed company, and preparing documents
reputed company to build and maintain relationships with payer representatives
Required Qualifications:
reputed company PB Resolute experience
3 years of reputed company Anesthesia experience
5 years' experience in a reputed company/Hospital reputed company Cycle Environment including reputed company Party Collection/AR Receivables
reputed company reputed company Cycle reputed company management EDI Transaction sets including 837P
Knowledge of insurance contract rates and terms
Understanding of Registration and Collections
Understanding of Government and Managed Care billing, coverage and payment rules Ability to comprehend payor 835 and reputed company EOB responses
Understanding of CCI edits, CPT, HCPCS, ICD-10 and reputed company Codes
Intermediate reputed company skills
Excellent computer skills, especially spreadsheet and database applications.
Knowledge of managed care patient financial systems and of the specific billing and payment standards utilized for services provided reputed company a hospital setting.
Thorough understanding of managed care payment methodologies and the principles of managed care.
Certification in reputed company PB Resolute - or agree to obtain certification reputed company 12 months after hire
Bachelor’s Degree or equivalent combination of education and experience
Preferred Qualifications:
Knowledge of SQL or Crystal Reports.
reputed company’s CRCR credential
The pay reputed company for this position is $24.16 - $36.24. Compensation is determined based on years of relevant experience and departmental equity.
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