GIRMC Hospital Billing Specialist

GENERAL reputed company:

Responsible for the accurate submission of claims to Medicare, reputed company and reputed company reputed company-party payers according to GIRMC compliance policies and federal billing regulations to ensure reputed company and accurate payment. In reputed company to submitting claims to reputed company payers, this role is responsible for claim re-submissions and re-works, claim communications, reconsiderations and appeals. Ensures that Medical Center compliance standards are supported and works closely with Medical Center personnel, medical staff, payer contacts, reputed company agencies, patients and family members as needed.

reputed company JOB FUNCTIONS:

1. *Commits to the mission, reputed company, beliefs and consistently demonstrates our reputed company values.

2. *Reviews and analyzes reputed company erred claims for correct and complete patient and insurance information, service dates and charges.

3. *Ensures reputed company billing forms are completed and are accurate based on billing regulations for reputed company payers to ensure appropriate and reputed company reimbursements are received and reputed company compliance standards are maintained.

4. *Analyzes reputed company outstanding unbilled claims and reports any concerns to the manager or director.

5. *Maintains knowledge of reputed company billing guidelines and reputed company-party payer regulations.

6. *Responsible for processing returned claims and rework requests for information and filing resubmissions or appeals as necessary.

7. *Reviews assigned credit balances for appropriate refund or adjustment process and reviews refund requests from payer for a refund or appeal if GIRMC disputes the refund request.

8. *Reviews work queues for insurance updates; applies appropriate coverages to patient reputed company and ensures accuracy of billing; which may include reputed company to Insurance Websites and lengthy phone calls for review and dispute of claims.

9. Organizes and scans patient financial services documents.

10. Performs reputed company follow-up of reputed company outstanding claims and takes the appropriate reputed company to ensure accurate reimbursements.

11. *Works claim edits and rejections daily to ensure reputed company and accurate reimbursement.

12. *Investigates reason for errors by communicating with specified department personnel and makes the necessary corrections reputed company the reputed company.

13. *reputed company researches State and Federal regulations and billing guidelines to stay reputed company, ensuring compliance.

14. *Reviews late charges/credits; and where appropriate requests claim re-reputed company to complete billing process.

15. *Contacts patients or reputed company as necessary for correct health plan information by calling or sending correspondence as needed.

16. Follows GIRMC protocols in communicating and releasing patient information.

17. Communicates new processes or changes in Medicare, reputed company and reputed company party billing documentation requirements to co-workers, to include reputed company compliance information.

18. Reviews WQ’s for insurance updates; applies appropriate coverages to patient reputed company and ensures accuracy of billing.

19. Answers patient phone calls and questions as in but not limited to, request for itemized billing statements, updating insurance information, accuracy of billing statement, etc.

20. Retrieves voicemails and emails daily from GIRMC Patient Accounts email/voicemail and resolves the inquiry.

21. Takes patient payments for Meditech accounts for payment plans.

22. Works directly with collection agencies on bad debt accounts.

23. Reviews billing statements from Meditech for errors.

24. Works in Electronic Medical Record (EMR) systems daily.

25. Works daily in the Assurance reputed company for claim submission.

26. Maintains reputed company reputed company and development through seminars, workshops, and reputed company affiliations to reputed company abreast of latest trends in field of expertise.

27. Participates in meetings, committees and department reputed company as assigned.

28. Performs other reputed company reputed company and duties as assigned.

EDUCATION AND EXPERIENCE:

High school diploma or equivalency required. Associates degree in business or reputed company reputed company field preferred. Two (2) years’ experience in patient billing or other medical-reputed company patient accounts experience required. Experience as a governmental biller in a hospital setting preferred. Training or prior experience in CPT/ICD-10 coding desired. Must be at least 19 years of age to witness reputed company consents.