Insurance Billing Specialist, Onsite

Insurance Billing Specialist, Onsite

Hopedale Medical Complex offers a unique opportunity for a skilled Insurance Billing Specialist to join our team on-site. As a key member of our revenue cycle department, you will play a crucial role in obtaining accurate reimbursement for hospital and hospital-based services.

Responsibilities:

• Insurance Claim Billing: Reviews patient accounts and verifies data for correct billable services and fees, ensuring all pertinent billing information is documented to produce a clean UB-04 claim.

• Reviews daily insurance billing reports and discrepancies, correcting accounts as necessary.

• Generates Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.

• Prior to submission, reviews each claim for accuracy and missing information, transmitting claims electronically to TruBridge.

• Follow up on any unpaid claim, follow-up on insurance denials and takes appropriate steps to resolve discrepancies.

• Communicates discrepancies and the need for additional information to the appropriate parties, obtain supporting documentation to appeal claim payment.

• All collection and follow-up efforts are annotated in the CPSI computer System.

• Re-bills accounts as needed.

• Ensures accurate Insurance Payments are received by reviewing explanation of benefits and verifying patient information, payer, and date of service for all transactions.

• Audits payments against contract terms, computes contractual allowances as needed.

• Non-collectible accounts are forwarded to the Revenue Cycle Director with supporting documentation to be written off.

• Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.

• Maintains assigned Accounts Receivable at minimal levels, regularly working and following up on all assigned accounts.

• Eliminates credit balances and generates refund requests for over payments as soon as possible.

• Serves as a resource person for staff inquiries regarding billing issues, assists with training of staff as necessary.

Knowledge/Skill/Ability Requirements:

• Routinely commutes to Hopedale, this is not a remote position.

• High School Diploma or some college preferred.

• Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.

• Working knowledge of medical billing/collection procedures.

• One to two years of experience in a medical business office including Insurance Claim follow up.

• Demonstrated working knowledge of a computerized medical information management system.

• Microsoft Office Suite skills (Word, Excel, Outlook).

• Excellent verbal and written communication skills required.

• Ability to work independently with only general supervision.

• Great attention to detail required along with high level of dependability.

• Excellent telephone techniques and rapport.

• Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.

Benefits:

• Tuition Reimbursement.

• Excellent benefits - health, dental, vision, and life and disability insurance.

• Quality childcare located on site.

• HMC Wellness Center membership.

• 401(k) plan with employer match.

Employee Daycare Rates:

• Infants (6 weeks to 15 months) - $133 weekly, $27 daily.

• Toddlers (15 months to 2 yrs) - $126 weekly, $26 daily.

• 2 years to 3 years - $119 weekly, $25 daily.

• 4 years to 5 years - $112 weekly, $23 daily.

Background and Drug Screen Disclaimer:
All HMC employees are required to pass a Federal and State background check and pass a drug and alcohol test. We test for illegal and legal substances, including marijuana.

Salary : $23 - $27