Summary: This role manages the full cycle of patient account processing with third-party payers, including electronic and paper claim billing, providing additional information for claim adjudication, and responding to inquiries from patients and insurance companies.

Education & Experience: Candidates should have at least two years of experience in electronic hospital billing or collections within a medical environment. A strong background in accounting and proficiency with personal computers, especially Microsoft Windows, is essential.

Requirements: Knowledge of third-party claim adjudication processes involving Medicare, Medicaid, Tricare, commercial insurance, and managed care is required. Familiarity with medical terminology and coding systems such as CPT, ICD-9/10, and HCPCS is preferred. Successful completion of departmental training with a minimum score of 75% on tests covering reimbursement calculations, UB-04 forms, patient account terminology, and system navigation is mandatory.

Applicants must demonstrate good verbal and written communication skills, analytical thinking, and accurate mathematical abilities. Near visual acuity, motor coordination, and finger dexterity are necessary to perform repetitive computer and office equipment tasks. The ability to lift up to 25 pounds and communicate effectively by telephone is also required.

Work Environment: This full-time, daytime position serves a regional healthcare network in the Southeastern United States, supporting a diverse patient population across multiple facilities and clinics.