Patient Billing & Insurance Claims Specialist

Cape Fear Valley Health; Karawang Barat; On-site; IDR 563,380,000 - 739,437,000; Full time

Job summary

Cape Fear Valley Health System in Fayetteville, NC, is seeking a patient accounts processor to manage complete processing of claims with third party carriers from start to finish. Responsibilities include electronic or paper billing, requesting information for adjudication, and responding to patient and insurer inquiries.

The role requires attention to detail, ability to navigate UB-04 and billing systems, and strong communication.

Qualifications

• High school diploma or equivalent required.
• 2 years’ experience with electronic hospital billing or collections in a medical field required.
• 1 year of experience with personal computer software and other office equipment required.
• 1 year of medical terminology and familiarity with CPT-codes, ICD-10 codes and HCPCS codes preferred.

Responsibilities

• Submits primary insurance claims to all carriers using the electronic claims terminal or send hard copy claims.
• Uses the on-line work list and account referrals to review accounts that are pending payment from insurance companies for additional information.
• Validates the accuracy of patient information so that future billing and follow-up activities are conducted effectively and to ensure a high degree of customer service.
• Applies adjustments and write-offs to accounts according to policy and procedure to assure accurate account balances and statements.
• Maintains a suspense file of accounts that need additional documentation for eligibility determination prior to billing.
• Receives incoming calls from patients and/or insurance companies concerning open accounts and answers questions and provides information in a courteous and cooperative manner to maintain good customer relations
• Other duties as assigned

Skills

English language proficiency

Analytical ability

Mathematical calculation

Customer service

Education

High school diploma

Tools

Billing software

UB-04 system

Office software

Job description

Cape Fear Valley Health System in Fayetteville, NC, is seeking a patient accounts processor to manage complete processing of claims with third party carriers from start to finish. Responsibilities include electronic or paper billing, requesting information for adjudication, and responding to patient and insurer inquiries.

The role requires attention to detail, ability to navigate UB-04 and billing systems, and strong communication.