Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Performs other duties as assigned.Responsibilities
Requirements, Preferences and Experience Education
- Communicates in detail with the clinical and billing staff along with payers and clients regarding various insurance and payment related issues
- Bills and submits claims for all insurance companies according to payer specific guidelines and established procedures and workflow. Be knowledgeable of payer updates as it relates to bundling and unbundling charges, medical necessity and general coding specifications.
- Reviews and processes adjustments as needed for accounts to avoid claim release if not needed but also recognizes and resolves credit balances as needed.
- Resolves all front end claim edits and clearinghouse returns so that clailm can be resubmitted in a timely matter to payers/insurance carriers.
- Corrects all of the primary/secondary rejected claims, the resubmission of rejected claims in along with resolution of all delinquent insurance claim on patient accounts, per guidelines, in order to secure payment
- Completes all assigned goals
Preferred: Certification in medical billing or course work. Associates degree in Business, Finance, or related field.
Minimum: High School Diploma or GEDExperience
Preferred: One or more years of government and/or commercial billing and collections in a physician or hospital setting.
Minimum: Experience in the healthcare setting or educational coursework.Training
Preferred: MS Office and advanced phone system experience. Knowledge of insurance billing and collections guidelines, including payer systems such as FFS. Experience with Epic. Effective verbal and written communication skills. Effective customer service skills.
Minimum: Basic computer and keyboarding skills.About Baptist Memorial Health Care
At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.At Baptist, We Offer:
- Competitive salaries
- Paid vacation/time off
- Continuing education opportunities
- Generous retirement plan
- Health insurance, including dental and vision
- Sick leave
- Service awards
- Free parking
- Short-term disability
- Life insurance
- Health care and dependent care spending accounts
- Education assistance/continuing education
- Employee referral program
Position: 5575 - Specialist-Billing
Facility: BMH-Central Business Office
Department: HS Central Business Office Corporate
Category: Billing Claims and Revenue
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Located in the Memphis metro area