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Insurance Biller

St. Elizabeth HealthCare

This is a Full-time position in Erlanger, KY posted May 17, 2021.

Job DescriptionBilling Responsibilities* Review bills and related information for accuracy and reasonableness of charges* Audit claims for overlap (charges, dates, coding, condition codes, modifiers, discharge status) and resolves issues with medical records and revenue department heads. (as applicable)* Work Specific Reports (as applicable)* Submit bills to payers electronically if possible, otherwise paper* Proficient in Commercial/Medicare/Medicaid Government regulations and reimbursement policies* Proficient in third party contractual agreements and regulations to apply requirements for accurate billing and to make recommendations for system changes as needed* Stay current with third party contractual arrangements and regulations (Medicare, Medicaid, Champus, managed care, etc.) to apply requirements for accurate billing and to make recommendations for system changes as needed.* Compute required adjustments to bills, balances to support, and inputs debits/credits to billing system to appropriate codes to ensure accurate billing.* Follow up on unbilled claims pending Medical Records coding, claim forms, etc. in order to bill on a timely basis.o Take appropriate action to resolve claims. Execute any, and all, steps to resolve unpaid, including but not limited to; rebill of claimo Perform due diligence on all collection efforts* Assist other associates when necessary, as determined by manager, work with staff to identify and resolve issues and develop standardo Elevate serious barriers to claim resolution to appropriate management* Demonstrate adequate, appropriate, and professional levels of communication with insurance company representatives, team members, supervisors, and managerso Record approved detailed note in the billing systemo Ensure expected reimbursement is secured with knowledge of billing system Expected Reimbursement data or payor contracto Meets productivity and quality standards on a weekly basiso Understand and adhere to the concepts of stratification* Demonstrate ability to work with high volume editso Ensure timely turnaround of internal requests (EOB’s, medical records)Seek opportunity for training and informs supervisor of all training needsCommunication/Trending* Trends weekly productivity, Billing CFB, Open AR* Edit WQs (Securing required data necessary for billing.)* Attends weekly billing staff meetings* Identifies payer & billing issues* Participates in a positive & constructive mannerRespond to internal and external customer calls or concerns.Continuing Education & Training* Seeks opportunity for training & informs supervisor of all training needs.Attends Seminars and workshops as assigned by manager, to obtain billing and/or follow up information related to specific payers.QualificationsEducation, Credentials, Licenses:* High School diploma or GEDSpecialized Knowledge:* PC Skills, including Word and Excel.* Detail Oriented* Customer Service Skills* Excellent Communication Skills* Billing or Follow Up experienceKind and Length of Experience:* One year’s experience in billing or follow-up activities* Experience in customer service, billing or related field.

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