Performs third-party billing for non-governmental payers, including commercial insurance carriers, HMOs, PPOs, EPOs, international payers, auto liability, and other liability carriers. Responsible for timely claim submission, claim follow-up, issue resolution, and maintaining productivity and quality standards.
Duties include preparing and submitting primary and secondary claims, working billing edits, reconciling complex accounts, identifying payer trends, documenting account activity, reviewing reports for overlap issues, working rejected claims, and completing late charge reports.
Requirements & Qualifications
Education and Experience
- High school diploma required; some college preferred
- Minimum 2 years of experience in a hospital setting
Skills and Knowledge
- Knowledge of CPT, HCPCS, HIPAA, UB-04, compliance, and regulatory issues
- Knowledge of billing systems and software applications
- Ability to reconcile complex claims and accounts
- Strong documentation, follow-up, and problem-solving skills
- Ability to maintain productivity and quality standards
Physical Requirements
- Ability to sit and stand for prolonged periods
- Good arm and hand dexterity
- Close and distant vision, color perception, and hearing required
- Ability to lift and move up to 25 pounds
Location
California, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
No
Posted
1 month ago
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