Overview: Join a dedicated team managing the full cycle of patient account processing with third-party payers. This role involves billing claims electronically or via paper, providing necessary information for claim adjudication, and addressing inquiries from patients and insurance companies with professionalism and care.

Key Responsibilities:

• Submit primary insurance claims to various carriers using electronic systems or paper methods.
• Review accounts pending payment for additional information using online work lists and referrals.
• Ensure accuracy of patient information to facilitate effective billing and follow-up activities, enhancing customer service quality.
• Apply adjustments and write-offs according to policies to maintain accurate account balances and statements.
• Maintain suspense files for accounts requiring additional documentation before billing.
• Handle incoming calls from patients and insurance representatives courteously, providing clear and helpful information.
• Perform other duties as assigned to support department goals.

Education:

High school diploma or equivalent is required.

Experience:

At least two years of experience in electronic hospital billing or medical collections is preferred. Familiarity with third-party claim adjudication including Medicare, Medicaid, Tricare, commercial insurance, and managed care is essential.

Skills and Knowledge:

• Understanding of medical terminology and familiarity with CPT, ICD-10, and HCPCS codes is advantageous.
• Proficiency with personal computer software and office equipment.
• Strong verbal and written communication skills.
• Analytical thinking and precise mathematical abilities.
• Successful completion of departmental training tests with a score of 75% or higher.

Physical Requirements:

• Good near vision and motor coordination for repetitive computer tasks.
• Ability to lift up to 25 pounds.
• Effective telephone communication skills.

This position serves a diverse regional population in the Southeastern United States, offering a supportive environment focused on integrity and patient-centered care.