Billing Representative - Rose International

JOB TITLE: Billing Representative
JOB ID: 94523
DURATION OR END DATE: 6 Months
HOURS: Monday-Friday 8:00am-4:30pm
LOCATION: Tampa, FL 33634 (Hybrid - minimum of 3 days per week onsite.)
Pay Rate: $20-$24/hr

The Billing Rep reports to the Billing Manager and is responsible for performing medical billing functions and providing administrative support to the Billing and Collections department. Positions in this function interact with customers and ancillary departments gathering support data to ensure invoice accuracy and work through specific billing discrepancies. Manage the preparation of invoices and complete reconciliation of billing with accounts receivables. May also include quality assurance and audit of billing activities.

ESSENTIAL FUNCTIONS:

•Consistently exhibits behavior and communication skills that demonstrate commitment to superior customer service, including quality and care and concern with every internal and external customer.
•Represents the Company in a professional manner, following all Company policies and procedures.
•Uses, protects, and discloses Optum Care patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards.
•Ability to establish and maintain effective and positive working relationships with staff and management.
•Ensures the timely submission of primary and secondary claims.
•Maintains current working knowledge of CPT and ICD 10 codes, required modifiers and encounter data.
•Performs electronic claims submission.
•Notifies management of issues arising from erroneous codes, missing information, and error/edit messages.
•Analyze relevant information to determine potential reasons for billing discrepancies and changes.
•Seek assistance from internal partners (e.g., Coding; Credentialing; Clinics; Contracting) and/or external stakeholders (e.g., individual customers/payers; brokers) to resolve billing issues.
•Reviews insurance claim forms for accuracy and completeness. Makes necessary corrections.
•Demonstrates and applies knowledge of Medicare and Medicaid guidelines in reviewing claims to ensure appropriate use of modifiers and CPT/ICD 10 codes.
•Review medical documentation to confirm appropriateness of codes when necessary.
•Corrects claims appearing on Edit Reports.
•Communicates system and claim formatting issues to the IT department and Billing Manager.
•Serves as a resource to Optum Care staff on general billing guidelines.
•Demonstrate understanding of business partners'' operations to identify appropriate resources for support and information.
•Perform quality checks on data entries prior to submitting information to internal and/or external customers/payers/clients.
•Inform customers/payers of billing problem/issue findings and resolution as appropriate.
•Contact external customers/payers to keep them informed of outstanding balances and required payment, as appropriate.
•Demonstrate and maintain understanding of state and federal regulatory requirements as they apply to billing operations (e.g., health-care reform; state surcharges; CMS)
•May conduct training (e.g., on-line demonstration; knowledge base; invoice inquiry) to co-workers (e.g., new staff members, collection/cash posting teams) on how to access, review, and/or submit claims for payments.
•Must be dependable and well organized.
•Performs additional duties as assigned.

EDUCATION:
•High school diploma, G.E.D. or equivalent
•Some college education preferred.

EXPERIENCE:
Minimum:
•CMC, CPC-A Certification
•Over 1 year of related job experience.
•CPT/ICD 10 codes experience.

Preferred:
•CPC Certification
•Previous coding experience.
•HMO/managed care, Medicare experience.
•Previous Allscripts, eCW, Athena, and/or RCX system experience.
•PCP and Hospitalist billing and coding experience.

KNOWLEDGE, SKILLS, ABILITIES:
•Computer literate.
•Microsoft Office skills
•Working knowledge of business billing office duties.
•Working knowledge of Medicare, Medicaid, and Managed care.
•Good verbal and written communication skills.
•Organized and detail oriented.
•Ability to work under time constraints.
•Bilingual preferred.

Benefits:

For information and details on employment benefits offered with this position, please visit here .Should you have any questions / concerns, please contact our HR Department via our secure website .

California Pay Equity:
For information and details on pay equity laws in California, please visit the State of California Department of Industrial Relations' website here.

Rose International is an Equal Opportunity Employer.All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender(expression or identity), national origin, arrest and conviction records, disability, veteran status or any other characteristic protected by law.Positions located in San Francisco and Los Angeles, California will be administered in accordance with their respective Fair Chance Ordinances.

If you need assistance in completing this application, or during any phase of the application, interview, hiring, or employment process, whether due to a disability or otherwise, please contact our HR Department.

Rose International has an official agreement (ID #132522), effective June 30, 2008, with the U.S. Department of Homeland Security, U.S. Citizenship and Immigration Services, Employment Verification Program (E-Verify). (Posting required by OCGA 13/10-91.).