Billing Services Representative

Saint Peter’s Healthcare System; Piscataway Township (NJ); On-site; USD 25,000 - 39,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision insurance

401(k) match

Adoption assistance

Free onsite parking

Back-up daycare

Job summary

Saint Peter’s Healthcare System is seeking a Billing Services Representative to ensure account accuracy and review daily claims for timeliness. The role involves monitoring charges, CPT-4/HCPCS coding, and denials; collaborating with payors and departments to resolve issues; and processing adjustments and patient transfers.

The position requires experience in medical billing, proficiency with Word/Excel, and strong interpersonal skills to lead patient accounts activities while adhering to HIPAA

Qualifications

• 1+ year experience in medical billing or hospital billing preferred.
• Proficient in Word and Excel.
• Strong interpersonal skills to lead and work with Patient Accounts staff.
• Knowledge of collection, A/R follow-up and billing processes.
• Familiarity with third-party payers and federal/state agencies.

Responsibilities

• Ensure account accuracy and review daily claims for timeliness.
• Monitor charges, modifiers, CPT-4s/HCPCS, payments, DRGs, ICD-10 coding.
• Review outstanding accounts using various reports.
• Submit adjustments, notes, patient balance transfers, and record requests.
• Work with management to address payor/department issues.
• Resolve issues and problems independently when possible.
• Utilize hospital information system and billing systems.
• Manage denials and appeals of administrative claims.
• Understand denials and proper handling.

Skills

Microsoft Word

Microsoft Excel

Interpersonal skills

Attention to detail

Deadline management

Tools

Hospital information system

Electronic billing system

Contract management system

Payer portals

Job description

Business Office

The Billing Services Representative will:

• Ensure account accuracy.
• Review daily claims to ensure submissions are clean and timely.
• Monitor charges/modifiers/CPT-4s/HCPCS/payments/DRGs/ICD-10 coding.
• Review outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances.
• Submit timely and accurate adjustments/notes/patient balance transfers and medical record requests.
• Work with management team and notifying of notifying of issues that arise with payors/departments/etc
• Resolve account issues and problem solving independently whenever possible.
• Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.)
• Manage denials and appealing administrative claims.
• Understand denials and how they should be handled.
• Send clinical denials and downgraded claims to appropriate parties to ensure timely appeal.
• Ensure claims denied at time of billing are distributed to appropriate parties for review.
• Update and correct accounts with assistance of originating departments (charges/authorizations/insurance issues).
• Follow departmental and hospital policy and procedure (this includes HIPAA guidelines and Federal guidelines).
• Understand payor contracts and billing guidelines; revenue codes and payor specific requirements; and payor/plan codes.
• knowledge of Medicare and Medicaid

Requirements

• Requires one (1)or more years experience as a Medical Insurance Biller or related responsibilities and Hospital Billing strongly preferred.
• Proficient in Microsoft Word and Microsoft Excel.
• Requires high level of interpersonal skills necessary to lead others and to work effectively with Patient Accounts Personnel as well as outside agencies.
• Must possess a comprehensive knowledge of Collection, A/R follow-up and Billing. Knowledge of third-party payers, State and Federal Agencies (constantly changing) with regards to Patient Accounting.
• Requires the ability to consistently meet deadlines, to concentrate and pay attention to details 75% of work time.

Salary Range: 18.47 - 28.61 USD

We offer competitive base rates that are determined by many factors, including job-related work experience, internal equity, and industry-specific market data. In addition to base salary, some positions may be eligible for clinical certification pay and shift differentials.

The salary range listed for exempt positions reflects full-time compensation and will be prorated based on employment status.

Saint Peter's offers a robust benefits program to eligible employees that will support you and your family in working toward achieving and maintaining secure, healthy lives now and into the future. Benefits include medical, dental, and vision insurance; savings accounts, voluntary benefits, wellness programs and discounts, paid life insurance, generous 401(k) match, adoption assistance, back-up daycare, free onsite parking, and recognition rewards.

You can take your career to the next level by participating in either a fully paid tuition program or our generous tuition assistance program. Learn more about our benefits by visiting our site at Saint Peter's .