Ar Hospital Billing Specialist

We're seeking a diligent individual to join our team in a vital role focused on Billing, Re-Billing, Post-payment, and Account Follow-up for our valued Client EMR Accounts Receivable. In this position, you'll handle a range of responsibilities, including account maintenance across various payers such as state and federal government programs, managed care, and commercial insurance groups. Collaboration with team members and health plans will be essential to ensure the timely and appropriate payment of claims. Above all, you'll embody our organization's core values, representing us with care and professionalism.
Primary Responsibilities:
Billing:
Scrutinize final billed initial claims for accuracy before submission to payers.
Calculate reimbursements based on Tier, Outlier, DRG, or other Fee Schedules.
Submit claims electronically or in hard copy with necessary attachments within designated filing timelines.
Maintain clear and concise documentation of all account activities.
Insurance Follow-up:
Engage with health plans via phone or online channels to track claim statuses within appropriate timeframes.
Document follow-up actions and escalate unresolved accounts per client expectations.
Post Payment Review:
Validate paid or partially paid claim statuses against client contract agreements.
Review and resolve denied, disallowed, or non-covered claims accurately.
Address technical issues with payers and process adjustments or refunds according to client procedures.
Prepare appeals and necessary documentation for claim denials.
Physical/Mental Demands, Environment:
Perform desk work involving prolonged computer usage.
Lift objects weighing up to 15 pounds.
Establish a secure home office environment to safeguard patient information in compliance with regulations.
Key Skills for Success:
Adherence to relevant regulations and laws.
Professional communication via video, phone, and email.
Effective prioritization to meet deadlines.
Consistent achievement of quality and productivity standards.
Positive attitude and energy.
Proficiency in critical thinking.
Ability to work independently and collaboratively.
High School diploma or equivalent.
2+ years of healthcare revenue cycle management experience preferred.
Advanced knowledge of CPT and ICD-10 coding.
Self-motivated with a commitment to quality work.
Proficiency in MS Office applications.
Familiarity with standard business processes and technical applications.
Certifications:
Active national certification CRCR through Healthcare Finance Management Organization (HFMA), or eligibility to obtain certification within 6 months of hire.
Employment Type: Full-Time
Salary: $ 18.00 23.00 Per Hour