This positions is PRN which means it is as needed. Hours will vary.
DUTIES INCLUDE BUT ARE NOT LIMITED TO:
• Works all identified insurance requirement edits through the electronic billing system.
• Communicates issues with patient access and facility departments.
• Researches required information and maintains pending follow up on a daily/weekly basis.
This applies to all untransmitted pending claims.
• Communicates daily information needed for billing to the Medicare Service Center via action notes
• Daily transmits all electronic claims to the billing vendor to be sent directly to the insurance carriers.
• Daily works electronic insurance rejects in order to retransmit with corrected insurance information.
• Daily works rebills submitted to the billing department through the electronic billing system.
• Daily/weekly verifies that all electronic acknowledgements were received by the insurance carriers.
• Daily submits required paper billing to insurance carriers.
• Attach I-bills, ER records, implant invoices to paper billing when required.
• Maintain daily follow up with the facility late charge reports.
• Late charges to be reviewed based on specific insurance payor requirements.
• Submit adjustment requests to Medicaid through online automated system.
• Work the unbilled alert and comp census reports daily.
• Work the Medicare 72 hour and Medicaid 24 hour reports to identify Compliance overlapping accounts.
Transfer charges when appropriate.
• Work all related Medicare APC edits that appear on the bill alert reports and communicate with facility
departments in order to resolve.
• Work the lab compliance related edits and communicates issues with facility lab directors.
• Enter notes in the collection system of action taken.
• Record daily productivity on excel spreadsheet.
• Practice and adhere to the "Code of Conduct" philosophy.
• Attend all required billing education classes.
• Other duties as assigned.
• High school diploma or GED required.
• At least one year billing experience required.
• Must be familiar with coordination of benefits (COB) rules and guidelines for billing secondary and tertiary payers.
• Must have hospital billing experience and be familiar with UB04 form locators.
• Ability to read and understand revenue cycle documentation required.
• Must be able to multitask and possess a basic understanding of government and commercial policies pertaining to COB and crossover transactions.
A little about us:
HCA is the nation’s leading private provider of healthcare services. Comprised of locally managed facilities which include 230,000 employees at over 160 hospitals, over 120 surgery centers and 100 urgent care facilities in 20 states and the United Kingdom