PB Claims Biller

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

📋 Description

• Serve as a point of contact for hospitals and clinics utilizing TruBridge’s comprehensive business office services.

• Prepare and electronically submit claims for hospitals, hospital-based physicians, and clinics to third-party insurance providers, as well as via hard copy when necessary.

• Obtain the medical documentation that is required or requested by third-party insurers.

• Follow up on outstanding claims until payment is received or a self-pay balance is established.

• Address claim rejections by rectifying billing errors or adjusting account privacy settings and resubmitting claims.

• Meet established production and quality assurance benchmarks.

• Uphold customer service standards in line with company and client policies.

• Ensure the confidentiality of customer information is maintained.

• Handle miscellaneous paperwork and assist with team projects.

• Aim for zero errors by submitting all claims on a daily basis.

• Follow up on the status of insurance claims and address inquiries from insurers.

• Read and analyze Explanations of Benefits (EOBs) and manage denial issues.

• Discuss reimbursement concerns and billing challenges with the Billing Manager/Supervisor.

• Review reports on late charges and either file corrected claims or write off charges in accordance with client policies.

• Evaluate readmission and overlapping-service-date reports, addressing them by ignoring, merging, or splitting bills per payer rules and client policies.

• Review credit reports, resolve payer credits when feasible, and submit credit listings to the facility as necessary.

⛳️ Requirements

• A minimum of 3 years of full-cycle physician/ambulatory billing experience is required.

• Experience with PB Epic within the last 3 years is mandatory.

• Proficient computer skills are essential.

• Familiarity with CPT and ICD-10 coding is necessary.

• Knowledge of medical terminology is required.

• Ability to communicate effectively with various insurance payers.

• Experience in filing claim appeals with insurance companies to maximize reimbursement.

• Responsible handling of confidential information is crucial.

• Strong written and verbal communication skills are needed.

• Capacity to manage multiple tasks simultaneously.

• Adherence to Equal Employment Opportunity laws, HIPAA, ERISA, and other relevant regulations is expected.

🏝️ Benefits

• Opportunities for education offered by the company.

• Protections under equal employment opportunity laws.