Location: Boston Region
Employment Type: Direct Hire
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:
• 2-3 years experience with medical billing/collection; hospital billing experience preferred.
• Knowledge of basic medical coding/terminology and third-party insurance operating procedures and practices a plus.
• Experience with patient accounting systems and billing/claim submission software; specific XClaim and/or Meditech experience a plus.
• Knowledge of revenue cycle and/or business office procedures.
• Ability to utilize basic Microsoft Office programs.
• 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 company.
• Medical billing and coding certification a plus.
I. Education: High School Diploma or GED
II. Experience (Type & Length): Experience within a healthcare consulting firm or large company preferred.
III. Five plus (5+) years of relevant work experience.