Billing Representative

This is a fully remote position, open to applicants in Michigan.

📋 Description

• Maintain a high level of confidentiality regarding sensitive medical information.

• Set priorities and adhere to deadlines by utilizing strong problem-solving skills.

• Stay updated on evolving billing standards and communicate relevant information to billing team members.

• Follow the daily priority matrix for assigned duties.

• Complete electronic billing transmissions for existing claims.

• Prepare and dispatch hard copy claims to insurance providers, patients, and other accountable parties.

• Follow up on unpaid claims every 30 days after the initial processing period of 45/60 days.

• Review and document procedures as necessary.

• Assess rejections for compliance with third-party payers and escalate issues to management as needed.

• Generate quarterly credit reports as mandated by Medicare.

• Report credit balances to insurance payers and process them according to payer guidelines within 30 days.

• Demonstrate a thorough understanding of hospital reimbursement contracts.

• Evaluate whether payments adhere to third-party payer reimbursement standards.

• Manage coordination-of-benefits claims in compliance with no-fault laws, regulations, and payer guidelines.

• Analyze patient claims and implement corrective actions, including auditing charges, adhering to 72/24-hour requirements, payments, and contractual agreements.

• Address payment inquiries with insurance providers.

• Verify insurance benefits on problematic accounts and assist patients with MSP/COB issues.

• Review Power Chart records to ensure services are distinctly separate when multiple charges are associated with an account.

• Utilize working knowledge of 3M CCI edits.

• Use Power Chart to gather and print records for hard copy Auto Accident and Workers’ Comp claims.

• Provide billing services to multiple facilities as required.

• Report to the financial class billing coordinator and support the team structure.

⛳️ Requirements

• A high school diploma or GED is mandatory.

• A minimum of two years of relevant work experience in customer service, healthcare, or a business environment is required.

• Knowledge of third-party payer reimbursement is essential.

• An associate degree is preferred.

• Experience in hospital billing (Rural health) is preferred.

• Candidates must be vaccinated or possess lab-confirmed immunity for Measles, Mumps, Rubella, and Varicella.

• A flu vaccine must be received during the flu season in the year of hire and annually thereafter, or an approved medical or religious exemption must be provided.

🏝️ Benefits

• Tuition reimbursement.

• Development opportunities both in-person and online.

• Access to a career hub.

• Comprehensive benefits package.

• Paid holidays.

• Generous paid time off (PTO).

• Employee discounts.

• Complimentary individual retirement counseling.

• Free wellness platform available for you and your family.

• Personalized support for personal or family challenges.

• Employee involvement in improvement huddles, employee surveys, and town hall meetings.