Hospital Billing Analyst, Patient Accounting, Bethesda East, FT, 8A-4:30P Remote

About the position Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission Protects payer filing deadlines by utilizing all available resources to resolve held claims assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as back up to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate reports any billing system issues to Billing management assists other Billing Specialists with claim resolution or other projects as assigned. Estimated pay range for this position is $16.04 - $19.41 / hour depending on experience.

Responsibilities

• working/editing daily download of assigned Managed Care/HOM claims
• optimizing the timely transmittal of accurate and clean claims daily
• identifying and obtaining invalid/missing claim data by communicating with other depts. to secure and/or correct the data which prevents claim transmission
• Protecting payer filing deadlines by utilizing all available resources to resolve held claims
• assuring all known regulatory, contractual, compliance, and BHSF guidelines are adhered to
• taking on additional queues as back up to billing all carriers
• Utilizing available system resources to resolve claim issues
• reporting any billing system issues to Billing management
• assisting other Billing Specialists with claim resolution or other projects as assigned

Requirements

• High School,Cert,GED,Trn,Exper.
• Prior Commercial and or Government billing experience required.
• Managed Care/HMO contract billing experience required.
• 3-5 years prior experience in Billing of claims.
• Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required.
• Knowledge and understanding of: Medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, On-line verifications (DDE) ; Internet savvy ; knowledge of Microsoft Suite a must.
• Extensive analytical ; critical thinking ; detail oriented ; problem solver ; good mathematical, writing, and interpersonal skills required.
• Must be able to communicate effectively with other depts. in order to resolve pending/missing information on claims to expedite the timely transmission to payers.
• Excellent Time-Management skills.
• Ability to multi-task and work under pressure in order to meet stringent deadlines.
• Minimum Required Experience: 3 Years

Nice-to-haves

• AA preferred or equivalent.
• Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus.
• Exp in other related Business Office Functions including Federal Programs, such as: Collections, refunds, review and adjudication of claims a plus.

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