St. Elizabeth Healthcare · 2 weeks ago
Insurance Biller
Kentucky, United States
Full-time
Onsite
Entry Level
1+ years expSt. Elizabeth Healthcare is a trusted provider of quality care across Kentucky, Indiana, and Ohio, dedicated to improving the health of the communities they serve. The Insurance Biller is responsible for timely and accurate billing of assigned accounts, ensuring compliance with various billing regulations and maintaining communication with supervisors regarding billing issues.
Health Care
Responsibilities
Review bills and related information for accuracy and reasonableness of charges
Audit claims for overlap (charges, dates, coding, condition codes, modifiers, discharge status) and resolves issues with medical records and revenue department heads. (as applicable)
Work Specific Reports (as applicable)
Submit bills to payers electronically if possible, otherwise paper
Proficient in Commercial/Medicare/Medicaid Government regulations and reimbursement policies
Proficient in third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed
Stay current with third party contractual arrangements and regulations (Medicare, Medicaid, Champus, managed care, etc.) to apply requirements for accurate billing and to make recommendations for system changes as needed
Compute required adjustments to bills, balances to support, and inputs debits/credits to billing system to appropriate codes to ensure accurate billing
Follow up on unbilled claims pending Medical Records coding, claim forms, etc. in order to bill on a timely basis
Take appropriate action to resolve claims. Execute any, and all, steps to resolve unpaid, including but not limited to; rebill of claim
Perform due diligence on all collection efforts
Assist other associates when necessary, as determined by manager, work with staff to identify and resolve issues and develop standard
Elevate serious barriers to claim resolution to appropriate management
Demonstrate adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managers
Record approved detailed note in the billing system
Ensure expected reimbursement is secured with knowledge of billing system Expected Reimbursement data or payor contract
Meets productivity and quality standards on a weekly basis
Understand and adhere to the concepts of stratification
Demonstrate ability to work with high volume edits
Ensure timely turnaround of internal requests (EOBs, medical records)
Seek opportunity for training and informs supervisor of all training needs
Complete special projects & tasks by the established time frame which can include organizing workload and/or associates for successful account resolution: proactively notify supervisor of any barriers that prohibit billing and/or payment of claims
Assume duties of supervisor or lead as needed. Assist co-worker in problem solving, with reports, meetings, etc
Complete other billing tasks and duties as assigned by manager
Execute training of contract staff (internal and external)
Act as a preceptor for new employees and as a resource within the department
Trends weekly productivity, Billing CFB, Open AR
Edit WQs (Securing required data necessary for billing.)
Attends weekly billing staff meetings
Identifies payer & billing issues
Participates in a positive & constructive manner
Respond to internal and external customer calls or concerns
Seeks opportunity for training & informs supervisor of all training needs
Attends Seminars and workshops as assigned by manager, to obtain billing and/or follow up information related to specific payers
Perform other duties as assigned
Qualification
Required
High School diploma or GED
One years experience in billing or follow-up activities
Experience in customer service, billing or related field
PC Skills, including Word and Excel
Detail Oriented
Customer Service Skills
Excellent Communication Skills
Billing or Follow Up experience
Benefits
Competitive pay and comprehensive health coverage within the first 30 days.
Generous paid time off and flexible work schedules
Retirement savings with employer match
Tuition reimbursement and professional development opportunities
Wellness, mental health, and recognition programs
Career advancement through mentorship and internal mobility
Company
St. Elizabeth Healthcare
St. Elizabeth Healthcare is one of the oldest, largest and most respected medical providers in the Greater Cincinnati region.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Vera Hall
Executive Vice President/Chief Operating Officer
Brad Hazelbaker
Network Services Manager
Recent News
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