Job Description

Job Description

Job Description

Insurance Billing Specialist, Onsite

JOIN THE BEST. TO BE THE BEST.

HMC Offers:

• Tuition Reimbursement
• Excellent benefits - health, dental, vision, and life and disability insurance
• Quality childcare located on site
• HMC Wellness Center membership
• 401(k) plan with employer match

Employee Daycare Rates

• Infants (6 weeks to 15 months) - $133 weekly, $27 daily
• Toddlers (15 months to 2 yrs) - $126 weekly, $26 daily
• 2 years to 3 years - $119 weekly, $25 daily
• 4 years to 5 years - $112 weekly, $23 daily

About the job:

Obtain accurate, ethical, and optimal reimbursement for hospital and hospital-based services, initiate follow-up of past due balances, handle all components of claims processing including management of disputed, rejected, and delayed claims. Develop a thorough understanding of third-party reimbursement requirements. Enter and electronically or hard copy submit billing data, as necessary. Know and understand all policies and procedures of Insurance Billing. Must be a problem solver, have organizational skills, attention to detail, excellent telephone technique and rapport, and computer knowledge. This is not a remote position.

Responsibilities:

1 Insurance Claim Billing

•Reviews patient accounts and verifies data for correct billable services and fees. Ensures all pertinent billing information is documented to produce a clean UB-04 claim.

•Runs daily insurance billing reports and reviews discrepancies. Corrects accounts, as necessary.

•Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.

•Prior to submission, reviews each claim for accuracy and missing information. Transmits claims electronically to TruBridge.

2 Insurance Claim Follow up

•Follow up on any unpaid claim.

•Follow-up on insurance denials and takes appropriate steps to resolve discrepancies.

•Communicates discrepancies and the need for additional information to the appropriate parties. Obtain supporting documentation to appeal claim payment.

• All collection and follow-up efforts will be annotated in the CPSI computer System.

• Re-bill accounts as needed.

3 Ensure accurate Insurance Payments are received

•Receive daily incoming payments and prepare for posting. Review explanation of benefits and verify patient information, payer, and date of service for all transactions.

•Audit payments against contract terms.

•Compute contractual allowances as needed.

•Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off.

•Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.

4 Accounts Receivable Management

•Monitor and maintain assigned Accounts Receivable at minimal levels.

•All assigned accounts are regularly worked and followed up on.

•Ensure any credit balances are resolved and generate refund requests for over payment as soon as possible.

5 Other Duties as Assigned

•Keep updated on all third-party billing requirements. Serves as a resource person for staff inquiries regarding billing issues.

•Assists with training of staff as necessary.

•Other duties as assigned.

Background and Drug screen Disclaimer:

All HMC employees are required to pass a Federal and State background check and pass a drug and alcohol test. We test for illegal and legal substances, including marijuana.

Knowledge/Skill/Ability Requirements:

• Must be able to reliably commute to Hopedale,  THIS IS NOT A REMOTE POSITION.
• Minimum of High School Diploma. Some college preferred.
• Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.
• Knowledge of medical billing /collection procedures.
• Prefer 1-2 years in medical business office including Insurance Claim follow up.
• Demonstrated working knowledge of a computerized medical information management system.
• Skills in Microsoft Office Suite (Word, Excel, Outlook).
• Good verbal and written communication skills required.
• Ability to work independently with only general supervision.
• Great attention to detail required along with a high level of dependability.
• Excellent telephone techniques and rapport.
• Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.

Compensation details: 24-26 Hourly Wage

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