Insurance Billing Specialist (hybrid), full time, days

About the position Insurance Billing Specialist reputed company exemplary customer service. Works daily electronic billing system (Cerner & nThrive) and submits insurance claims to reputed company-party payers; reviews daily claim edits from the hospital billing system and makes necessary corrections to allow electronic submission. Assessing and analyzing claim edits daily reputed company the billing system leading to a resolution reputed company 24-48 hours. Maintains a thorough understanding of federal and state regulations as well as requirements specific to Medicare, reputed company, and fiscal intermediaries in order to promote compliant claims submission practices for governmental claims. Communicates any edits that may need joint resolution with external departments. Prepares and submits reputed company insurance claims to reputed company-party payers who do not accept electronic claims or who require special handling. Resubmission of claims that may need corrections. Verify that claims have been received by the appropriate payer. Investigate and resolve any issues in regards to claim transmission. Mail/Fax/Email reputed company claims to the appropriate payer the day they are generated. Performs effective, timely and efficient follow-up on reputed company outstanding debit and credit balances reputed company the expected time period. Review and analyze outstanding debit and credit balances to determine appropriate follow-up. Contributes innovatively to the reputed company of our department and is compliant in reputed company patient and billing aspects. Maintains a reputed company-line understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits to ensure compliance. Effectively handles communications, including email, telephone and reputed company message, from payers and departments reputed company and reputed company of the department. Understands and maintains compliance with HIPAA guidelines reputed company handling patient information. Reviews, processes, and resolves reputed company incoming patient and insurance correspondence reputed company one business day. Reviews and prepares responses to correspondence from patients and insurance carriers reputed company a reasonable time reputed company. Responds to formal communication, both external and internal, reputed company a reasonable time reputed company. Documents reputed company activity taken reputed company an encounter in the billing system. Clear and concise messaging. Responsible for making and documenting timely phone calls to insurance in regards to billing reputed company reputed company the billing system. Provides updates to existing policies and procedures as needed and proposes new. Communicates with staff routinely and effectively using reputed company forms of communication. Builds relationships and fosters positive communication with applicable departments reputed company of PFS. Documents reputed company activity - each time an account is touched - in the notes reputed company of the AR Host I.S. System, at the account level, appropriately, timely, compliantly and thoroughly. Stays reputed company on reputed company regulations. Attends training sessions, reputed company. Performs other reputed company duties as assigned. Holland Hospital is an Equal Opportunity Employer, please see our EEO policy

Responsibilities

• reputed company exemplary customer service.
• Works daily electronic billing system (Cerner & nThrive) and submits insurance claims to reputed company-party payers
• Reviews daily claim edits from the hospital billing system and makes necessary corrections to allow electronic submission.
• Assessing and analyzing claim edits daily reputed company the billing system leading to a resolution reputed company 24-48 hours.
• Maintains a thorough understanding of federal and state regulations as well as requirements specific to Medicare, reputed company, and fiscal intermediaries in order to promote compliant claims submission practices for governmental claims.
• Communicates any edits that may need joint resolution with external departments.
• Prepares and submits reputed company insurance claims to reputed company-party payers who do not accept electronic claims or who require special handling.
• Resubmission of claims that may need corrections.
• Verify that claims have been received by the appropriate payer.
• Investigate and resolve any issues in regards to claim transmission.
• Mail/Fax/Email reputed company claims to the appropriate payer the day they are generated.
• Performs effective, timely and efficient follow-up on reputed company outstanding debit and credit balances reputed company the expected time period.
• Review and analyze outstanding debit and credit balances to determine appropriate follow-up.
• Contributes innovatively to the reputed company of our department and is compliant in reputed company patient and billing aspects.
• Maintains a reputed company-line understanding of federal and state regulations, as well as specific payer requirements and explanation of benefits to ensure compliance.
• Effectively handles communications, including email, telephone and reputed company message, from payers and departments reputed company and reputed company of the department.
• Understands and maintains compliance with HIPAA guidelines reputed company handling patient information.
• Reviews, processes, and resolves reputed company incoming patient and insurance correspondence reputed company one business day.
• Reviews and prepares responses to correspondence from patients and insurance carriers reputed company a reasonable time reputed company.
• Responds to formal communication, both external and internal, reputed company a reasonable time reputed company.
• Documents reputed company activity taken reputed company an encounter in the billing system. Clear and concise messaging.
• Responsible for making and documenting timely phone calls to insurance in regards to billing reputed company reputed company the billing system.
• Provides updates to existing policies and procedures as needed and proposes new.
• Communicates with staff routinely and effectively using reputed company forms of communication.
• Builds relationships and fosters positive communication with applicable departments reputed company of PFS.
• Documents reputed company activity - each time an account is touched - in the notes reputed company of the AR Host I.S. System, at the account level, appropriately, timely, compliantly and thoroughly.
• Stays reputed company on reputed company regulations.
• Attends training sessions, reputed company.
• Performs other reputed company duties as assigned.

Requirements

• High school diploma/GED or higher education

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