Hospital Billing Specialist
工作总结：PB Epic Claims Biller 职位负责使用 TruBridge 的完整商务办公服务为医院和诊所提供联系人。他们与 TruBbridge 管理层和医院员工密切合作，以支付所有医院，医生和临床账单的保险公司费用。他们追求收取所有的索赔直到保险公司支付；并执行其他与发票流程相关的工作。这些目标和目标不应被解释为完成的所有任务的完整声明；员工将需要履行其他工作相关责任。目标和目标可能会变化。所有活动都必须符合平等就业机会法，HIPAA,ERISA 和其他规定。基本功能：除了按照我们的绩效因素规定的工作外，该职位的具体责任包括：· 电子方式或纸张账单向第三方保险公司准备和提交医院，医生和诊所索赔。·确保需要的医疗文件或要求的第三方保证机构。· 在未支付索赔之前跟踪第三方保險公司的未偿索赔或者只剩余自费资金。·通过将账户私有化或纠正任何收费错误并向第三方保险公司重新提交索赔。·负责持续满足生产和质量保障标准。·通过遵循公司政策，程序以及每个客户的特定政策和程序来保持优质的客户服务。·通过参与公司提供的教育机会更新实操了解。·保护客户信息，保证所有信息都是机密性的。·处理各种文件。·与具有困难过程的高调度客户合作的能力。·经常被要求帮助团队项目。·确保每天提交所有索赔，以实现零错误的目标。·及时对保险索赔状况进行追踪。·阅读和解释 EOB （福利说明）. ·响应保险公司的询问。·拒绝管理。·与账单经理/监督员会面讨论并解决退款问题或账单障碍。·审查迟到收费报告，并根据客户政策提交纠正索赔或取消收费报告。· 审查报告识别你。
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Job Summary:
The PB Epic Claims Biller position is responsible for acting as a liaison for hospitals and clinics using TruBridge’s complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all hospital, hospital-based physician and clinic bills. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process.
These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change.
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.
Essential Functions:
In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
- Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.
- Secures needed medical documentation required or requested by third party insurances.
- Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
- Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers.
- Responsible for consistently meeting production and quality assurance standards.
- Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
- Updates job knowledge by participating in company offered education opportunities.
- Protects customer information by keeping all information confidential.
- Processes miscellaneous paperwork.
- Ability to work with high profile customers with difficult processes.
- May regularly be asked to help with team projects.
- Ensure all claims are submitted daily with a goal of zero errors.
- Timely follow up on insurance claim status.
- Reading and interpreting an EOB (Explanation of Benefits).
- Respond to inquiries by insurance companies.
- Denial Management.
- Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.
- Review late charge reports and file corrected claims or write off charges as per client policy.
- Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy.
- Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.
Minimum Requirements:
Education/Experience/Certification Requirements
- 3 years of physician/ambulatory billing (Full Cycle) experience REQUIRED
- PB Epic experience REQUIRED (within the past 3 years)
- Computer skills.
- Experience in CPT and ICD-10 coding.
- Familiarity with medical terminology.
- Ability to communicate with various insurance payers.
- Experience in filing claim appeals with insurance companies to ensure maximum reimbursement.
- Responsible use of confidential information.
- Strong written and verbal skills.
- Ability to multi-task.
Business SupportOriginally posted on Himalayas