Patient Rep Biller Full Time Days
2 months ago
Hollywood Presbyterian is seeking a highly skilled Medical Claims Specialist to join our team. As a Medical Claims Specialist, you will be responsible for reviewing claims for accuracy, expediting billings to payers and patients, and ensuring that all necessary documentation is submitted with claims.
Key Responsibilities- Review claims for accuracy and completeness, and ensure that all necessary documentation is submitted with claims.
- Expedite billings to payers and patients, and follow up on any issues or discrepancies.
- Determine payer documentation requirements for payment, and ensure that all necessary information is available to be submitted with claims.
- Transmit and submit clean claims to payers, and update the computer system to reflect submission and transmission of claims.
- Review correspondence from payers, and provide corrections and/or documentation as needed.
- Review payment data for suspension, underpayment, and denials, and submit appropriate responses.
- Review bi-monthly accounts receivable reports to identify claims that have been submitted but not resolved or acknowledged, and take appropriate action to ensure resolution.
- Prepare adjustments to ensure that balances reflect payable amounts, and forward to management for review and authorization.
- High school diploma or equivalent.
- Three years of billing experience in a hospital setting, or five years of relevant hospital experience.
- Knowledge of payer requirements and medical terminology.
- 30 wpm typing and the ability to operate all department equipment and software programs.
- N/A
This is a full-time position, working 40 hours per week, with a shift of 8:00am - 4:30pm, Monday through Friday.
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