Senior Billing Representative

Senior Billing Representative The Senior Billing Representative is responsible for the timely and accurate submission of hospitals’ primary, secondary, and tertiary patient bills to Medicare, Medicaid, Blue Cross, commercial, and other insurance payors. This role also serves as a backup to the Billing Team Lead and communicates payor issues, delays, and concerns to Leadership and customers as needed. Primary Job Duties

• Coordinate hospital daily billing within controls to ensure all billing is completed and abides by billing techniques and standards as established by hospital / MEDHOST Business Services.
• Assist Team Lead with planning daily workflow and work distribution to ensure the billing inventory for assigned customers is managed and the company’s billing goals are met.
• Communicate directly with Team Lead / Manager of issues impairing the billing process, impacting claim resolution, and required tools for effective billing.
• Assist Team Lead with reviewing and approving adjustments weekly.
• Build and maintain strong, long-lasting customer relationships.
• Work in partnership with other teams / departments regarding resolution of billing / payor payment issues and concerns.
• Assist billing representatives and follow-up representatives with questions related to billing activities.
• Assist team in working claims generated on the late charge reports, rejected claims, claims in error, DDE claims, and ghost claims daily.
• Ensure facility rebills are worked and comments logged on patient accounts within 7 business days.
• Monitor and ensure staff work within Medicare DDE system to resolve RTP claims daily for their assigned customers.
• Actively participate in customers’ weekly, bi-weekly, and / or monthly meetings to review billed account inventory as needed, with focus on performance reporting and issue resolution.
• Verbally and in writing, communicate with customers to retrieve information for rebills / corrected claims and communicate with insurance payors to work claims not processed / paid. Working outstanding claims will require a broad range of strategies including phone calls, letters, faxing, emails, rebilling, and filing corrected claims.
• Assist with high severity requests and billing issue escalations.
• Perform billing activities and coordinate billing workload coverage when there are unplanned staffing outages.
• Timely and appropriate processing of billing / rebilling requests from customers and team members within the department.
• Continue education of billing practices for private and government payors.
• Maintain working knowledge of software applications related to billing claims to payors.
• Assist in the training and education of new and existing employees.
• Perform other duties as assigned. Additional Job Duties
• Assist with creating and maintaining department and customer documentation.
• Provide training and training documentation in areas of expertise necessary to assist team members and customers.
• Maintain in-depth knowledge of the MEDHOST core products and third-party clearinghouses utilized for billing.
• Maintain industry knowledge through self-study and attending training classes.
• Attend and participate in team and departmental meetings.
• Adhere to all HIPAA Privacy and Security requirements and responsibilities.
• Complete duties as assigned. Requirements
• High-speed internet access and unlimited data.
• Smartphone for DUO authentication. About Us For more than 40 years, MEDHOST has provided innovative healthcare solutions, including an integrated EHR, helping healthcare facilities achieve operational, financial, and clinical excellence. Our solutions serve hospitals, clinics, and healthcare systems, empowering them to deliver the highest quality care.