Responsible for monitoring billing processes and making corrections as needed. Manages the timely and accurate posting of charge data for both patient and client-billed accounts. Identifies, corrects, and maintains appropriate billing data within the information system. Ensures all claims billed meet government-mandated procedures for integrity and compliance, resolves insurance claim errors and regulatory edits, handles customer billing inquiries, and serves as a resource for billing and compliance activities.
Responsibilities
- Researches, identifies, and submits appropriate coding and billing requests
- Acts as the technical expert
- Performs pre-submission audits of coding and documentation and monitors activities to ensure compliance with billing and internal standards in accordance with Medicare and Medicaid regulations
- Maintains knowledge of insurance and payer billing requirements
- Identifies trends in billing issues, system issues, and payer-specific requirements
- Maintains knowledge of the Meditech computer system and the electronic billing system, using system features effectively to support billing activity
- Audits and reconciles each department to ensure all billable services and items are charged appropriately
- Maintains charge master files and routinely reviews professional and technical charges, updating them per compliance guidelines
- Identifies opportunities to recoup and prevent future loss of billing revenue
- Provides technical support to the hospital's coding team to ensure accurate coding and billing
- Performs other duties as assigned
Requirements & Qualifications
Education and Skills
- High school diploma or GED
- Certified coder preferred
- Computer literacy required, specifically in Microsoft Office
- Proficiency with spreadsheets and word processing applications required
- Working knowledge of financial accounting and billing procedures
- Completion of medical terminology and anatomy/physiology courses, medical coding/billing certification, or related experience required to classify procedure codes
Experience
- Minimum 4 years of extensive CPT and ICD-9/10-CM coding experience required
- Thorough knowledge of third-party and government payor regulations required
Licenses and Certifications
- Medical billing certification preferred
- Medical coding certification preferred
Location
Texas, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
3 weeks ago
Browse More Jobs