Richardson, Texas 75080
POSITION SUMMARY: This position is responsible for billing all claims based on third party claim processing rules within established timelines. The billing associate reports to the central business office supervisor or manager.
- Prepares and submits clean claims to insurance companies either electronically or by paper in an accurate, timely and compliant manner.
- Collects and verifies all documentation necessary for timely billing of patient accounts, including requesting and collecting medical records and other documents ensuring the acceptance of the claim.
- Works all reports related to billing, such as work-lists, hold reports, and rejection reports to ensure claims are submitted timely and accurately, per billing guidelines.
- Processes claims for secondary insurance carriers, attaching all required documentation to ensure claims are filed to appropriate payers.
- Understands all payer guidelines related to claim submission; is knowledgeable and proficient with payer websites and other useful resources pertaining to the billing function.
- Focuses daily on complying with policies, processes and department guidelines for billing and claim edit resolution.
- Maintains strict confidentiality and adheres to all HIPAA guidelines/regulations.
REQUIRED KNOWLEDGE & SKILLS:
- Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus.
- Knowledge of revenue cycle and/or business office procedures.
- Highly detail oriented and well organized.
- Ability to read, understand and follow oral and written instructions.
- Ability to establish and maintain effective working relationships and communicate clearly with customers and insurance companies both within and outside of the company
- Medical billing and coding certification a plus.
- Education: High School Diploma or GED.
- Experience: 2-3 years’ experience with medical billing/collection; hospital billing experience preferred. Experience within a healthcare consulting firm or large company preferred. Five plus years of relevant work experience.
- Software/Hardware: Microsoft Office suite; Experience with patient accounting systems and billing/claim submission software; Specific XClaim and/or Cerner experience a plus.