Hospital Billing Analyst

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

📋 Description

• Accountable for managing and editing the daily download of assigned Managed Care/HOM claims, ensuring the prompt submission of precise and clean claims each day.

• The Billing Specialist I is tasked with identifying and acquiring any invalid or missing claim data by collaborating with other departments to secure and/or rectify the information that hinders claim transmission.

• Safeguards payer filing deadlines by employing all available resources to resolve held claims, ensuring compliance with all known regulatory, contractual, compliance, and BHSF guidelines.

• Must be prepared to handle additional queues as a backup for billing across all carriers.

• Leverages available system resources to address claim issues when appropriate, reports any billing system problems to Billing management, and assists fellow Billing Specialists with claim resolutions or other assigned projects.

⛳️ Requirements

• High School diploma, Certificate, GED, Training, or Experience.

• Associate's degree preferred or equivalent experience.

• Previous experience in Commercial and/or Government billing is essential.

• Experience in Managed Care/HMO contract billing is required.

• 3-5 years of prior experience in claim billing is necessary.

• Familiarity with all required fields on a 1500 and/or UB form for hospitals and diagnostic facilities is essential.

• A background in coding or a coding certification (CPC, CPC-H, CCS, or RMC) is advantageous.

• Experience in other related Business Office Functions, including Federal Programs such as Collections, refunds, and claim review and adjudication, is a plus.

• Knowledge of medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD-9/10, CPT-4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, Online verifications (DDE), proficiency with the Internet, and familiarity with Microsoft Suite is required.

• Strong analytical and critical thinking skills, attention to detail, problem-solving abilities, and good mathematical, writing, and interpersonal skills are essential.

• Must be able to communicate effectively with other departments to resolve pending or missing information on claims, expediting the timely submission to payers.

• Excellent time-management skills are required.

• Ability to multitask and work under pressure to meet strict deadlines.

🏝️ Benefits

• Opportunities for career growth and development.

• Comprehensive health and wellness resources that extend beyond traditional benefits.

• A wellness program designed to assist employees in eliminating their medical plan deductible, thus reducing out-of-pocket healthcare costs.

• Tuition reimbursement to facilitate continued learning and career advancement.