Billing Representative, Revenue Cycle

Job Summary

The Billing Representative submits hospital or professional claims to payers, including Medicare, Medicaid, Managed Medicare, Managed Medicaid, Managed Care, Commercial, Workers Compensation, and Champus/Tricare.

Essential Functions

• Perform code and demographic audits on paper and electronic claims using the billing scrubber, payer edits, and custom edits for accuracy.
• Communicate specific problems or concerns to the manager as appropriate.
• Review electronic claims transmission reports and resolve ECS rejections by correcting them in the system and resubmitting for payment.
• Request or post charge corrections and appropriate credit and debit adjustments to patient accounts.
• Correct patient demographic information when updated or correct information is received.
• Review claims for accuracy and completeness, obtain missing information, and work rejected claims using compliant and ethical billing practices.
• Identify and bill secondary or tertiary insurance as needed.
• Perform other duties as assigned or requested.