Billing Senior Representative - Remote - United States

JOB SUMMARY 

Responsible for processing incoming requests from various departments to bill manual and electronic claims to ensure timely and complete collection of all dollars assigned. 

ESSENTIAL DUTIES AND RESPONSIBILITIES

Include the following. Others may be assigned.

• Working knowledge of various billing processes and the ability to support answering team questions and training up team members. 
• Works closely with leadership to review reports, scrub inventory and escalate identified denial payor trends and training opportunities.
• Skillset to work across multiple markets and systems to provide inventory coverage.
• Proficient in building upon skills in a fast-paced environment and adaptable to change.
• Bill primary claims appropriately completing the billing requirements via electronic submission or paper claims including any attachment of required documentation.
• Properly submit claims to secondary and tertiary insurance companies with the appropriate Explanation of Benefits (EOB) attachments, if applicable.
• Complete subsequent billing to third party payors to include rebills, secondary billing and/or special billing.
• Fulfill paper billing payer requirements with submitting itemized statements, medical records, and any required forms to process the claim.
• Review billing editor for all edits on UB04 and 1500 claim forms types related to charges, coding and patient information prior to billing to minimize underpayment, denials, and re-bill attempts.
• Responsible for verifying correct insurance information is loaded into demographics using VI, account notes and related accounts as resources.  
• Responsible for routing accounts with needed updates for valid billing to the appropriate department or contact utilizing the workflow process.
• Review the editor and/or control ID for all unbilled accounts and/or rebill requests. Bill all late charges with proper billing codes, per Late Charge Workflow.
• Notate accounts with proper activity codes for workflow back to the facilities for review …