Prepares all hospital related claims for submission to all insurance companies, governmental programs, and workers compensation.
- 1 to 3 years experience
- High School Diploma or GED
- Reviews all claims for accuracy and completeness prior to submittal. Requests medical records as required by insurance for billing purposes.
- Downloads, transmits, and maintains electronic billing/reports on a daily basis. Reviews all reports including rejections in the hold and the Master Claim Rejection Report and makes correction within one day of the error being received.
- Identifies trends with billing edits or billing system issues. Communicates anything identified to team, supervisor, and departments impacted.
- Updates/revises standard work processes regularly, ensuring they are current. Actively contributes to continual process improvements.
- Prepares hardcopy claims and secondary claims for submittal to payors, including pulling EOB’s and RA’s.
- Reviews revenue codes, dates of service, CPT codes, and insurance information to
- Works with departments and managers to resolve charging issues follow up on Charge Corrections timely ensuring prompt completion.
- Ensure accurate and compliant billing.
- Documents all transactions on the patient’s accounts system.
- Provides back up for peers as needed. Performs other duties as assigned.