Hospital Billing Specialist at APPALACHIAN REGIONAL HEALTHCARE INC

Whitesburg, Kentucky, United States -

Full Time

Start Date

Immediate

Expiry Date

13 May, 26

Salary

0.0

Posted On

12 Feb, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Billing, Insurance Follow-Up, UB Claim Forms, HCFA Claim Forms, EOB Interpretation, Denial Handling, Charge Import, Diagnostics Coding, Procedural Coding, Claim Resubmission, Accounts Receivable, HIPAA Compliance, Computer Proficiency, Typing Speed, CPT Coding, ICD-9 Coding

Industry

Hospitals and Health Care

Description

Overview Under general supervision, the Hospital Billing and Follow-Up Specialist handles essential billing and insurance follow-up functions. This role requires a fundamental understanding of insurance claim processing, knowledge of UB and HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handle denials, and perform follow-up with insurers to ensure claims resolution. The position encompasses business office responsibilities related to patient accounts, including charge import, diagnostics and procedural coding, and claim follow-up with third-party payers to achieve a zero-balance resolution. Special Instructions Possibility of having a hybrid schedule after 6 months fully onsite, per managers approval Responsibilities Promote the mission, vision, and values of the organization · Import charges from queues in a timely manner and append modifiers or any required information for claim transmission · Review daily accounts that are ready to be billed in Waystar from Meditech · Initiate correction on all claims with errors by the designated time · Follow up on any correspondence that may have been received on that day or the previous day · Cross train on billing all lines of business to the different payers · Pull listing of all accounts assigned to be follow up by specific payer · Diagnostic and procedural coding Follow-Up Responsibilities · Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies. · Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims. · Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts. · Maintain accounts receivable detail of their accounts through tasking. · Maintains standards per payer for percentage accounts >90 days. · Works minimum standard number of accounts per payer per day. · Meets or exceeds collection goals by payer each month. · Works all assigned accounts as assigned, depending on balance. · Participates in educational activities and attends monthly department staff meetings. · Maintains confidentiality: adheres to all HIPAA guidelines/regulations. · Other duties as assigned from time to time. · Attend educational activities and monthly department staff meetings · Perform other duties as assigned Qualifications Education · High School Diploma or GED Minimum Work Experience · Six months previous experience in hospital registration, billing and collections, financial counseling, or customer service preferred Required Skills, Knowledge, and Abilities · Knowledge of medical terminology preferred · Basic computer proficiency · Typing speed: minimum 40 WPM · Familiarity with CPT and ICD-9 coding is helpful · Good written and verbal communication skills are essential for account follow-up

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Responsibilities

The specialist will handle essential billing and insurance follow-up, including importing charges, reviewing accounts in Waystar, and correcting errors on claims ready for transmission. Responsibilities also involve following up with third-party payers to resolve denials and achieve zero-balance resolution on patient accounts.