Medical Billing - Irving, United States - YASMESOFT INC

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    Job Description

    Job Description
    Must have experience working on UB-04 Claims for Hospital/Facility. Should work on A/R Follow up.
    Experience in Hospital/Facility billing required.

    Job Purpose

    The representative is responsible for collections, account follow up, billing allowance posting for the accounts assigned to them


    Duties and Responsibilities
    Ability to use various workflow system and client host system such as STAR, SMS, EAGLE and EPIC, as well as other tools available to them to collect payments and resolve accounts
    Working knowledge of the insurance follow-up process with understanding of the fundamental concepts in healthcare reimbursement methodologies
    Understanding of government, Medicare and Medicaid claims
    Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
    Review and updates all patient and financial information accurately as given.
    Verifies that information is accurate as to individual or insurance company responsible for payment of bill.
    Monitors all billings for accuracy, updating any that contain known errors.
    Monitors Medicaid/healthy options coupons to assure services are billed within expected timeframes
    Bills all hospital services to primary insurer or patient correctly and within expected timeframe
    Follows up with insurance companies on all assigned accounts within expected timeframe
    Explains hospital regulations with regard to methods for payment of accounts and maintains complete working knowledge of insurance regulations and hospital insurance contracts
    Identify and report underpayments and denial trends
    Ability to analyze, identify and resolve issues causing payer payment delays Initiate appeals when necessary
    Basic knowledge of healthcare claims processing including: ICD-9/10, CPT and HCPC codes, as well as UB-04
    Ability to manipulate excel spreadsheets and communicate results
    Meets and maintains daily productivity and quality standards established in departmental policies
    Act professionally, cooperatively and courteously with patients, insurance payors, co-workers, management and clients
    Perform special projects and other duties as needed by the management team.
    Maintain confidentiality at all times

    Use, protect and disclose patients protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.

    Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties


    Qualifications
    Experience in Hospital/Facility billing required
    2-3 years experience in insurance collections, including submitting and following up on claims
    Ability to work well individually and in a team environment.
    Proficiency with Microsoft Office including Excel and Word
    Strong organizations, communication and written skills
    Basic math and typing skills
    High School Diploma
    Medical Billing and Coding certification preferred, but not required

    This is a remote position.