Hospital Biller II

This is a fully remote position, open to applicants in Alabama, +43 more states.

📋 Description

• Review and verify hospital claims for accuracy, completeness, compliance, and performance of clean claims.

• Submit compliant electronic claims to government, commercial, and managed care payers.

• Complete hospital service billing within established timeframes.

• Rebill corrected claims to reduce payment delays and ensure proper reimbursement.

• Prioritize and manage assigned work queues effectively.

• Analyze recurring denial and rejection trends and suggest corrective measures.

• Provide peer support and workflow guidance to less experienced colleagues.

• Monitor billing work queues and address claim edits, rejections, and front-end edits.

• Escalate complex billing or payer issues for prompt resolution.

• Collaborate with registration, credentialing, and provider offices to acquire missing or corrected information.

• Communicate with internal departments to enhance claim resolution processes.

• Ensure compliance with federal, state, payer, and organizational billing regulations.

• Safeguard patient information in line with HIPAA and privacy standards.

• Document claim activities, payer communications, appeals, and resolutions.

• Achieve productivity, quality, denial resolution, and account aging standards.

• Identify trends and support ongoing improvement in billing performance.

• Participate in departmental meetings, training sessions, and process enhancement initiatives.

⛳️ Requirements

• Advanced understanding of hospital billing, claims processing, denial management, and reimbursement methodologies.

• Strong knowledge of CPT, HCPCS, ICD-10-CM, and payer billing requirements.

• Familiarity with electronic claim submissions and billing work queues.

• Exceptional attention to detail and organizational abilities.

• Capability to analyze claim errors and recommend corrective actions.

• Strong problem-solving, critical-thinking, and analytical skills.

• Excellent organizational and communication capabilities.

• Proficiency in Microsoft Office applications.

• Capacity to train team members while maintaining productivity standards.

• Preferred proficiency with Epic Hospital Billing.

• Associate’s degree in a relevant field preferred; alternatively, a High School Diploma or GED with two additional years of related experience.

• Certification as a Biller is preferred but not mandatory.

• Associate’s degree with five years of billing experience in a medical billing environment, or a High School Diploma with seven years of billing experience in a medical billing setting.

• Ability to perform essential functions with or without reasonable accommodation, including prolonged sitting and computer usage, frequent keyboarding, occasional standing, walking, bending, and lifting or moving items up to 20 pounds.

• Adequate visual acuity to review electronic documents, reports, and financial data.

• Ability to work during East Coast operational hours following Eastern Time.

🏝️ Benefits

• Remote work arrangement.

• Opportunities to enhance skillset and mentor others.

• Participation in departmental training and process improvement initiatives.

• Reasonable accommodations for essential job functions.