Job Details

Job Title

Responsible for working/editing daily download of assigned Governmental Program claims while adhering to all regulatory, contractual, compliance and BHSF mandates/guidelines. Optimizes timely transmittal of accurate and clean claims to achieve daily set thresholds. Protects payer filing deadlines by utilizing all available resources to resolve held claims. Communicates effectively with all BHSF Departments responsible for Revenue Cycle delays and works with Billing Management to achieve resolution. Responsible for training new employees and assisting management with auditing queues during the probation period. Must be willing to take on additional queues as back up to bill all carriers. Estimated pay range for this position is $20.02 - $24.22 / hour depending on experience.

Qualifications:

Degrees:

• High School,Cert,GED,Trn,Exper.

Additional Qualifications:

• BA preferred or equivalent Medicare or Medicaid Billing experience required.
• 4-7 years prior experience in Billing of claims.
• CPC, CPC-H, CCS, RMC certifications a plus.
• Current BHSF employees must have a high fully meets or exceeds merit rating 3.
• Ability to train personnel a must.
• Know all required fields on a 1500 and UB for hospitals and diagnostic facilities a must.
• Extensive knowledge with Govt related regulations National, State, and Local, for Medicare, Medicaid,Champus/Tricare.
• Medical Necessity and Correct Coding Initiative a must.
• Exp in other related Business Office functions incl Government Funded programs.
• Adjudication of claims is desirable.
• Working knowledge and understanding of: medical terminology ; Revenue Codes ; DRG guidelines ; ICD9/10, CPT4, Modifiers & HCPC codes ; HIPAA ; Online verifications DDE ; Internet savvy ; Knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good math, writing, and interpersonal skills required.
• Must be able to report issues to management, IT support.
• Communicate with other depts in order to resolve pending or missing inf on the claim to meet daily transmissions.
• Excellent Time Management skills.
• Ability to multi-task and work under press.

Minimum Required Experience: 4 Years

EOE, including disability/vets