Billing Associate - AHN Cancer Institute / Radiation Oncology - Forbes

Highmark Health; Monroeville (Allegheny County); In loco; USD 42.000 - 56.000; Tempo pieno

Descrizione del lavoro

Highmark Health in Monroeville, PA seeks a billing associate to process pro-fee billing activities and post payments across office, hospital, and outpatient settings.

You will enter charges using CPT/ICD-9 coding, verify insurance, and handle payer denials while maintaining HIPAA compliance and regulatory standards.

Competenze

• High school diploma or GED; or 1–3 months related training or equivalent.
• 1–3 years healthcare billing experience.
• Graduate of a medical billing program preferred.
• Medical Records training and OASIS education.

Mansioni

• Posts co-payments, patient payments, and insurance payments (paper and electronic); reconciles payments and denials.
• Prepares and deposits payments; uses CPT, ICD-9, and payer codes/modifiers to enter charges.
• Assists customers with patient billing inquiries and identifies unpaid balances via AR reports.
• Obtains and enters patient demographic, insurance, and referral/precertification information.
• Verifies insurance information; ensures claims are sent to carriers timely.
• Maintains knowledge of federal/state reimbursement policies; ensures compliance.
• Performs other duties, including supporting front end office processes.

Conoscenze

Healthcare billing

HIPAA compliance

Formazione

High school diploma or GED

Medical billing program graduate (preferred)

Descrizione del lavoro

GENERAL OVERVIEW

This job processes pro-fee billing activities.

ESSENTIAL RESPONSIBILITIES

• Posts co-payments, patient payments, and insurance company payments (paper and electronic), and denials. Performs reconciliation of payments.
• Prepares and deposits payments received. (25%) Uses CPT, ICD-9, and payer specific codes and modifiers to prepare and enter charges for entry (includes office, hospital, and outpatient charges). (20%)
• Assists customers with patient billing inquiries. Identifies unpaid balances (insurance and patient) through A/R reports and takes appropriate actions. (25%)
• Obtains and enters patient demographic, insurance, and referral/precertification information in the billing system. (10%)
• Verifies insurance information via hospital and insurance carrier systems. Ensures that electronic and paper claims are sent to insurance carriers in a timely manner. (10%)
• Maintains current knowledge of federal and state reimbursement policies/regulations and system policies pertaining to billing. Ensures compliance with regulatory requirements. (10%)
• Performs all other duties as assigned, including but not limited to supporting front end office processes.

QUALIFICATIONS

• Minimum High school diploma or GED; or one to three months related experience and/or training; or equivalent combination of education and experience.
• 1-3 years’ healthcare billing experience.
• Preferred Graduate of a medical billing program.
• Medical Records training and OASIS education.

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.

Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies. As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times. In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law. California Consumer Privacy Act Employees, Contractors, and Applicants Notice Highmark Health is a national, blended health organization that includes one of America’s largest Blue Cross Blue Shield insurers and a growing regional hospital and physician network. Based in Pittsburgh, Pa., Highmark Health’s 35,000 employees serve millions of customers nationwide through the nonprofit organization’s affiliated businesses, which include Highmark Inc., Allegheny Health Network, HM Insurance Group, United Concordia Dental, HM Health Solutions and HM Home & Community Services. Highmark Health’s businesses proudly serve a broad spectrum of health-related needs including health insurance, health care delivery, population health management, dental solutions, reinsurance solutions, and innovative, technology solutions.