Medicaid/Medicare Billing Specialist at Hudson Regional Hospital

Clifton, New Jersey, United States -

Full Time

Start Date

Immediate

Expiry Date

20 Sep, 26

Salary

24.0

Posted On

23 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Insurance Claims Processing, Claim Denial Resolution, Medicare Billing, Medicaid Billing, HMO Billing, Analytical Skills, Organizational Skills, Customer Service, Problem Solving, Billing Software Proficiency

Industry

Hospitals and Health Care

Description

Position Summary Responsible for accurately and efficiently processing insurance claims, primarily Medicaid, Medicare and Medicare and Medicaid HMO’s. Job Duties * Monitor the progress of insurance claims from submission to payment. * Identify and resolve claim denials, rejections, and delays. * Follow up with insurance carriers to expedite claim payments. * Review daily electronic billing reports, paper claim submissions, and third-party confirmation reports for errors. * Make necessary corrections in the billing system to ensure accurate claims. * Process Medicare RTP claims and denial reports on a daily basis. * Ensure timely and accurate submission of Medicare credit balance quarterly reports. * Research outstanding accounts and take appropriate action to secure prompt payment. * Analyze system-generated reports to identify accounts requiring research. * Document all resolution activities in the appropriate system and log. * Alert supervisors or managers of non-payment trends. * Research partial payments to determine if the appropriate contractual allowance was calculated. * Initiate corrective action for miscalculated allowances, including collaboration with clinical departments. * Document results and alert supervisors or managers of trends. * Complete productivity reports and submit to supervisors within the established timeframe. * Support the department's customer service and performance improvement goals. * Collaborate with other staff to enhance patient care and service. * Maintain strict confidentiality of patient information. * Performs all other duties as assigned. Qualifications and Skills * Excellent customer service skills and problem solving skills. * Strong analytical and organizational skills. * Ability to interact with varying cultures and a diverse population. * Proficient in billing systems and software. Education, Experience and Certification/Licensure Requirements * H.S. Graduate * 1-3 years’ experience in hospital or healthcare billing * Working knowledge of Medicare, Medicaid and HMO billing regulations.

Responsibilities

Responsible for processing and monitoring Medicaid, Medicare, and HMO insurance claims from submission to payment. This includes resolving claim denials, researching outstanding accounts, and ensuring accurate contractual allowances.