Responsible for billing third-party payers through a claims processing vendor and/or handling appeals for denied professional and hospital claims. The role identifies billing issues affecting hospital and physician accounts, follows up on outstanding claims, and takes action to ensure timely reimbursement and account resolution. The position also works within Epic Resolute to update account information, process adjustments and refunds, and support departmental policies and procedures.
Requirements & Qualifications
Minimum Qualifications
- Two years of financial experience or one year of patient accounts experience.
Preferred Qualifications
- 2+ years of experience in hospital billing denials resolution with Medicaid payers.
- 2+ years of experience in medical billing and revenue cycle operations, including claims, EOBs/remits, cash posting, eligibility/registration, and coding.
- 2+ years of experience working with various payers using payer websites, claim status tools, provider manuals, policies, and reimbursement methodologies.
- 2+ years of experience using work queues and documenting account notes.
- 2+ years of analytical and problem-solving skills, including the ability to identify root causes and trends.
Additional Job Knowledge
- Understanding of CPT, ICD-9, HCPCS, modifier coding, and POS requirements.
- Knowledge of state and federal payer billing regulations.
Location
Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
1 month ago