Hospital Biller - Exceptional Healthcare Inc.

Job Summary:   A Hospital Biller is a vital member of the healthcare finance team, playing a pivotal role in ensuring the financial health of medical facilities. This position involves a comprehensive range of responsibilities aimed at facilitating accurate and timely reimbursement for medical services provided. The Hospital Biller is entrusted with managing the intricacies of the billing process, from meticulously reviewing medical documentation to interacting with insurance companies and patients.
Job Responsibilities/Duties:

• One of the primary responsibilities is to oversee billing procedures, meticulously generating, and submitting claims to various insurance providers and payers. This requires a keen eye for detail to verify the completeness and accuracy of patient information, diagnoses, and procedures, ensuring adherence to coding standards such as ICD-10 and CPT.

 

• Insurance verification is a crucial aspect of the role, necessitating a thorough understanding of insurance policies and procedures. The Hospital Biller confirms patient insurance coverage, obtains necessary authorizations, and ensures compliance with insurance requirements to streamline the billing process.

 

• In addition to coding and billing tasks, this role involves proactive follow-up on outstanding claims. The Hospital Biller monitors and addresses claim denials, engaging in effective communication with insurance companies to resolve issues and secure timely payments. This requires a strategic and persistent approach to ensure optimal financial outcomes for the healthcare facility.

 

• Patient communication is another key facet of the role, involving interactions to explain billing details, assist with financial inquiries, and establish payment arrangements. A successful Hospital Biller is not only adept at navigating the technical aspects of billing but also possesses strong interpersonal skills to engage with patients in a clear and empathetic manner.

 

• Staying updated on healthcare regulations and insurance policies is imperative to ensure compliance with industry standards and legal requirements. The Hospital Biller is expected to maintain organized and accurate billing records, generate insightful reports on financial performance, and collaborate effectively with other healthcare professionals to create a seamless billing process.

 

• Overall, the role of a Hospital Biller demands a blend of technical proficiency, attention to detail, strong communication skills, and a commitment to navigating the complex landscape of healthcare finance to optimize revenue streams for the medical facility.

• Perform other duties as assigned.

Qualifications & Experience:
 

• 2-5 years of experience in outpatient billing and collections
• Working knowledge of NCCI editing
• Knowledge of Commercial and Government payor and Worker’s Comp guidelines
• Proficient in medical terminology, HIPAA, and other critical governmental regulations
• Organized, detail-oriented, and ability to meet deadlines.
• Ability to comprehend various insurance documentation, analyze and reconcile accounts and follow detailed procedures in an organized and efficient manner.
• Strong computer skills (Word, Excel, billing software)

PHYSICAL DEMANDS

• Requires visual acuity to inspect and analyze work close to the eyes and ability to hear sound with or without correction; Ability to climb, stoop, kneel, reach, stand, walk pull, push lift, and able to exert up to 40 pounds of force occasionally and/or up to 10 pounds of force constantly to move objects.
• Moderate physical activity performing somewhat strenuous daily activities of a primarily administrative nature.
• The physical demands for this position include adequate vision, hearing, and repetitive motion. 
• Ascending or descending stairs, ramps, and the like, using feet and legs and/or hands and arms.
• Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner - Bending legs downward and forward by bending leg and spine - Standing, particularly for sustained periods of time.

Using upper extremities to exert force to draw, drag, haul or tug objects in a sustained motion. 

• Raising objects from a lower to a higher position or moving object horizontally from position to position

WORK CONDITIONS

• While performing the duties of this job, the employee is frequently required to stand, walk, sit, reach with hands and arms, and talk or hear.
• The employee is occasionally required to stoop, kneel, crouch, or crawl and taste or smell.
• The employee is required to have close visual acuity to perform and activity such as: preparing and analyzing data and figures, transcribing, and viewing a computer terminal.

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