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Medical Billing Representative

2 months ago

Pasadena, Texas, United States Catholic Health Initiatives Full time
Job Summary

Catholic Health Initiatives is seeking a skilled Medical Billing Representative to join our team. As a Medical Billing Representative, you will be responsible for processing hospital claims in a timely and accurate manner, resolving billing software edits, and working closely with various departments to ensure accurate and complete diagnosis/procedure codes and modifiers are reported to insurance carriers.

Key Responsibilities
  • Process hospital claims electronically and in hard copy to insurance carriers, ensuring timely and accurate submission.
  • Resolve various billing software edits, including missing or invalid information, CCI edits, and incorrect patient information.
  • Collaborate with Health Information Management (HIM), departments, and Revenue Integrity to resolve billing issues and ensure accurate coding and reporting.
  • Resolve claim rejections by correcting and resubmitting claims to insurance carriers.
  • Review accounts in designated work queues for resubmission and/or correction.
  • Maintain a working knowledge of ICD-10 and CPT codes.
  • Reconcile daily late charge reports.
  • Stay up-to-date on billing guidelines and regulations.
  • Handle sensitive and confidential information in accordance with HIPAA regulations.
Requirements
  • High School Diploma or GED equivalent.
  • Knowledge of Hospital UB04.
  • 1-2 years of medical insurance billing experience, preferably in a hospital setting.
  • Working knowledge of HIPAA regulations.
  • Understanding of Electronic Health Records (EHR) and billing software applications.
  • Experience with Direct Data Entry (DDE) is a plus.