At Memorial Hermann, we pursue a common goal of delivering high quality, efficient care while creating exceptional experiences for every member of our community. When we say every member of our community, that includes our employees. We know that when our employees feel cared for, heard and valued, they are inspired to create moments that exceed expectations, while prioritizing safety, compassion, personalization and efficiency. If you want to advance your career and contribute to our vision of creating healthier communities, now and for generations to come, we want you to be a part of our team.
Job Summary
Position is responsible for performing daily analysis and monitoring status of transmitted claims to verify acceptance for adjudication process by payer category.Education: Associates degree or equivalent experience.
Licenses/Certifications: (None)
Experience / Knowledge / Skills:
Three (3) years hospital business office experience with insurance billing and/or managed care
Strong analytical and problem solving skills
Knowledge of ICD-10 and CPT codes
Proficient PC skills (Word processing, maintenance and design of spreadsheets, maintenance and design of Access data bases, Maintenance of PC’s and Printers within the department)
Effective oral and written communication skills
Principal Accountabilities
Analyzes daily reports to determine status of transmitted claims shown as accepted for adjudication process by payer category.
Determines type of errors for unprocessed accounts, corrects errors, and submits for retransmission.
Communicates with management and staff regarding developing trends reflected in the types of unprocessed claims.
Tracks and monitors the Discharged – Not Billed report.
Documents communications with third party payers and internal employees.
Prepares various compliance, productivity, and status reports.
Prepares third party billing and remains current in billing and payment requirements.
Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
Demonstrates commitment to caring for every member of our community by creating compassionate and personalized experiences. Models Memorial Hermann’s service standards by providing safe, caring, personalized and efficient experiences to patients and colleagues.
Other duties as assigned.