Responsible for billing third-party payers through a claims processing vendor and handling appeals for denied professional and hospital claims. The role identifies billing issues affecting hospital and physician accounts, takes action to ensure timely claim filing, performs follow-up activities, and works to resolve reimbursement issues and account balances.
The position is hybrid remote with standard business hours, Monday through Friday, and no weekends or rotating shifts.
The work environment includes standard hospital, clinical, laboratory, and office settings, using standard office equipment.
Requirements & Qualifications
Minimum Qualifications
- Two years of financial experience, or one year of patient accounts experience.
Preferred Qualifications
- Experience with end-to-end revenue cycle operations, including billing, denials, and collections.
- Knowledge of insurance verification, claims processing, and reimbursement guidelines.
- Experience working with commercial, Medicare, and Medicaid payers.
- Experience with Epic or a comparable patient accounting/EHR system.
Key Skills and Duties
- Knowledge of state and federal payer billing regulations.
- Basic understanding of CPT, ICD-9, HCPCS, modifier coding, and POS requirements.
- Billing hospital and professional patient accounts.
- Resolving payer rejections and performing claim corrections.
- Following up on assigned accounts and responding to correspondence.
- Reviewing denied claims, identifying underpayments, and submitting appeals.
- Updating account records in Epic Resolute.
- Processing adjustments, refunds, and payment validation.
- Communicating professionally with customers, colleagues, and vendors.
- Supporting team goals and assisting with training new employees.
Location
Texas, US
Employment Type
Full-time
Experience Level
Associate
Remote work allowed
Yes
Posted
2 weeks ago