Medicare Managed Care Billing and Collections Specialist

at  Northside Hospital

Northside Hospital is award-winning, state-of-the-art, and continually growing. Constantly expanding the quality and reach of our care to our patients and communities creates even more opportunity for the best healthcare professionals in Atlanta and beyond. Discover all the possibilities of a career at Northside today.

OCCUPATIONAL SUMMARY

Bills and collects on Medicaid/Medicare accounts in a timely and accurate manner.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION REQUIRED

• One (1) year experience in billing, OR Associate’s Degree in Business.
• Good verbal communication skills and basic typing ability.

KNOWLEDGE SKILLS AND ABILITIES/LICENSE OR CERTIFICATION PREFERRED

• B.S. degree in Business or Accounting.
• Two (2) years experience in insurance billing, or related area.
• Prior hospital or healthcare experience.
• Demonstrated knowledge of electronic billing systems.
• Managed care collection experience.

In addition to the items listed above in Section A, Billing Clerks assigned to the Medicare/Medicaid Billing function in the Billing Office are responsible for the following:

• Reviews and prepares UB-92 and HCFA-1500 claim forms for submission to Medicare, Medicaid, and Champus in a timely and accurate manner.
• Maintains current status with daily billing download as well as all secondary claims, cross-over forms and referrals from other departments.
• Reviews, corrects and follows up on all Medicare claims via the Florida Shared System maintaining an acceptable status.
• Maintains a current working knowledge of all changes in billing guidelines and regulations for Medicare, Medicaid and Champus.
• Works with other departments to resolve billing issues and ensure compliance with all Government regulations.
• Practices proper safety techniques in accordance with hospital and departmental policies and procedures. Immediately reports any mechanical or electrical equipment malfunctions, unsafe conditions, or employee/patient/visitor injury‑accident to Manager