Billing Representative

Billing Representative

Overview
The Billing Representative is responsible for the timely and accurate submission of patient bills to various insurance payors, including Medicare, Medicaid, Blue Cross, commercial, and other government entities. This role involves managing billing processes, maintaining customer relationships, and ensuring financial goals are met.

Responsibilities

• Coordinate daily hospital billing within established controls to ensure adherence to billing guidelines and standards.
• Manage billing inventory for assigned clients and meet financial goals.
• Build and maintain strong customer relationships.
• Maintain working knowledge of all software applications related to billing claims.
• Process claims generated on late charge reports, rejected claims, claims in error, DDE claims, and shadow claims daily.
• Ensure facility Rebills are worked and comments logged on patient accounts within 7 business days.
• Communicate issues impairing the billing process to the Team Lead/Manager.
• Communicate with hospitals to retrieve information for rebills/corrected claims.
• Communicate with insurance payors to work claims not processed/paid, utilizing various strategies such as phone calls, letters, meetings, faxing, and emails.
• Partner with other teams/departments to resolve billing/payor payment issues.
• Submit billing/rebilling requests from customers and team members in a timely manner.
• Stay current with billing practices for private and government payors, including billing software applications.
• Assist in the training and education of new and existing employees.
• Maintain the effectiveness and implementation of the MEDHOST Quality Management System and meet applicable regulatory requirements.
• Perform other duties as assigned.
• Accurately input/submit worked time by departmental deadlines.
• Maintain in-depth knowledge of MEDHOST core products and third-party clearinghouses.
• Maintain industry knowledge through self-study and training.
• Recommend department and customer documentation.
• Provide training and training documentation in areas of expertise.
• Attend and participate in team and departmental meetings.
• Respond to emails, telephone calls, voicemails, Microsoft Teams messages, and correspondence from facilities in a timely manner.
• Adhere to all HIPAA Privacy and Security requirements.
• Perform duties in a positive manner that upholds company policies and procedures.

Requirements

• High School or equivalency diploma required.
• Minimum 1 year of experience in a hospital billing/patient account receivable related environment.
• Minimum 1 year of experience utilizing hospital claims management/billing software.
• Ability to follow directions and perform work according to department standards independently.
• Computer skills in Microsoft Office applications (Word, Excel, PowerPoint, etc.).
• Customer Service oriented.
• High Speed Internet access (minimum 300 Mbps download speed) and unlimited data.
• Smart phone for Multi Factor Authentication (MFA) application.

What Would Make You Stand Out

• MEDHOST (HMS) knowledge is a plus.
• Knowledge of hospital billing, revenue cycle, and medical terminology.
• Thorough understanding of accounts receivable, collections, billing, appeals, and denials.
• Knowledge and understanding of Explanation of Benefits (EOB), state, and federal guidelines.
• Ability to navigate healthcare information system(s) and clearinghouse(s).
• Ability to access protected health information (PHI) in accordance with departmental assignments and guidelines.
• Skilled in making accurate arithmetic computations.
• Excellent communication skills (verbal & written), good judgment, tact, initiative, and resourcefulness.
• Detail-oriented, organized, and able to multi-task.
• Ability to demonstrate supportive relationships with peers, clients, partners, and corporate executives.
• Flexible with a “can do” attitude and ability to remain professional under high-pressure situations.

What We Offer

• 3 weeks' vacation and 5 personal days
• Comprehensive medical, dental, and vision benefits starting from your first day
• Employee stock ownership and RRSP/401k matching programs
• Lifestyle rewards
• Remote work and more

About Us
MEDHOST, founded in 1984 and headquartered in Franklin, Tennessee, is a leading provider of healthcare information technology solutions. Serving over 1,000 healthcare facilities nationwide, MEDHOST offers a comprehensive suite of products, including electronic health records (EHR), financial management systems, and patient engagement platforms. Their mission is to empower healthcare organizations to enhance patient care and improve business operations through innovative, user-friendly solutions. In January 2024, MEDHOST was acquired by N. Harris Computer Corporation, further strengthening its position in the healthcare IT industry.