Responsible for a range of billing processes related to managing ready-to-bill unbilled revenue. This role ensures the timely and accurate billing of patient accounts to meet or exceed departmental goals for cash collections and accounts receivable.
Key responsibilities include:
- Managing pre-bill edits and claim scrubber edits for accuracy and compliance before submission to payers.
- Following state, federal, and system policies related to compliance, integrity, and ethical billing practices.
- Working with UB04 and CMS 1500 claim forms and required data elements.
- Billing all services within timely filing requirements.
- Resolving billing-related denials and identifying trends to improve clean claim rates.
- Preparing daily reporting of billing indicators using reporting tools.
- Reviewing and resolving combined billing requirements to ensure compliance.
- Working referrals within a 24/48-hour turnaround time.
- Communicating professionally with coworkers and multiple departments.
- Performing other duties as assigned.
Requirements & Qualifications
Minimum Requirements
- High school diploma or equivalent.
- At least 4 years of electronic billing and/or billing editing experience in a hospital and/or physician office setting.
- General knowledge of HCPCS, CPT-4, ICD-9/10 coding, and/or medical terminology.
- Familiarity with multiple payer requirements and claims processing regulations.
- Strong Microsoft Office skills.
- Good communication skills and the ability to interact professionally with multiple departments.
Preferred Requirements
- Healthcare-related associate or bachelor's degree.
- 5+ years of billing experience in a hospital and/or physician billing setting.
- Experience billing both technical and professional charges.
- Experience with DDE.
- Experience with combined/consecutive billing workflows and issue resolution.
- Knowledge of commercial insurance billing, payer-specific requirements, claim edits, and denials.
- Experience reviewing EOBs and interpreting payer responses.
- Previous experience in hospital billing, preferably in an acute care or health system environment.
- Working knowledge of EPIC Hospital Billing.
- Experience working hospital billing work queues.
- Preferred certifications: Certified Revenue Cycle Associate (CRCA) and Certified Professional Coder-Hospital Services (CPC-H).
Location
South Carolina, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
4 weeks ago