Billing Specialist

ECU Health; Greenville (NC); Remoto; USD 24.000 - 35.000; Tempo pieno

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Great Benefits

Descrizione del lavoro

ECU Health is seeking a Billing Specialist to manage pre- and post-billing edits and maximize reimbursement. Responsibilities include generating and transmitting claims for hospital and physician services to payors, collaborating across Revenue Cycle departments, and ensuring compliant, timely submissions.

Strong detail orientation and effective communication with payers and internal teams are essential. The role requires familiarity with HCPCS, CPT-4, ICD-10, and payer guidelines, with Epic

Competenze

• High School Diploma or equivalent or higher required.
• 4 years electronic billing and/or billing editing experience in hospital/physician settings.
• Familiar with HCPCS, CPT-4, ICD-10 coding and medical terminology.

Mansioni

• Perform all pre-bill edits and claim scrubber edits for accuracy and compliance before submission.
• Bill all services within timely filing guidelines per departmental/insurance guidelines.
• Handle billing denials to identify trends and improve clean claim rates.
• Generate daily billing indicators and reports using various tools.
• Attach documentation for payment with hardcopy claims when needed.

Conoscenze

Billing edits

Pre-bill edits

HCPCS/CPT-4/ICD-10

Denials analysis

Communication skills

Attention to detail

Problem solving

MS Office

Epic experience

Formazione

High School Diploma or higher

Strumenti

Epic software

Billing software

Microsoft Office

Descrizione del lavoro

Position Summary

The Billing Specialist ensures consistent edit resolution to promote optimal reimbursement by timely completion and appropriate management of pre and post billing edits. Generating, reviewing and transmitting claims for hospital and physician services to government and/or non-government payors. Collaborating across Revenue Cycle departments to ensure billing edits and other up-front billing-related issues are resolved completely and efficiently. Attention to detail is a critical component of this position, as well as the ability to communicate with insurance companies, other areas within the revenue cycle, and clinical areas.

Responsibilities

• Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers.
• Responsible to bill all services within a timely filing as defined by departmental goals and insurance guidelines.
• Responsible for all billing related denials to identify trends to improve clean claim rates.
• Responsible for multiple daily reporting of billing indicators through various reporting tools.
• Bills hardcopy claims attaching any needed documentation for payment.
• Pulls EOB's and Medical Records as needed attaching to claims and mailing.
• Contact patients. insurance, any third party for insurance information or any additional billing data.
• Performs rebill projects and additional daily reports.
• Must understand and comply with the rules regarding edits.
• Must possess a good working knowledge of the UB04 and CMS 1500 claim form and the data elements/field data required.
• Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical billing practices.
• Work and completes appropriate reports and workqueues.
• Escalate issues with payers and reports improvement as appropriate.
• Complete special reports or projects as assigned by Supervisor/Manager or Director.

Minimum Requirements

• High School Diploma, equivalent or higher is required.
• 4 years electronic billing and/or billing editing experience in a hospital and/or physician office setting.
• Working knowledge of HCPCS. CPT-4 and ICD-10 coding and medical terminology.
• Familiar with multiple payer requirements and regulations for claims processing.
• Epic experience a plus.

Preferred License/Registration/Certifications

• Certified Revenue Cycle Associate (CRCA)
• Certified Professional Coder- Hospital Services (CPC)
• Certified Coding Specialist (CCS)

Knowledge, Skills And Abilities

• Ability to work independently in carrying out oral and written instructions.
• Apply knowledge of CPT, HCPCS and ICD-10 coding guidelines, billing documentation and documentation standards to daily claims management.
• Excellent problem solving, analysis, organizational and time management skills.
• Excellent communication and customer service skills with the ability to cooperatively resolve end user issues quickly and accurately, while building relationships with internal personnel and external contacts.
• Strong attention to details, accuracy and completeness of work products and thoroughness of research, data entry and recordkeeping.
• Computer proficiency with Microsoft (Word, Excel, Outlook, Power point) and Internet applications.
• Knowledge of third-party physician billing along with a demonstrated understanding of automated processes and claims submission.
• Demonstrates the ability to accurately manage detailed information.
• Proficient in using billing software and Microsoft Office Suite (Excel, Word)
• Understands basic medical terminology.
• Excellent analytical and problem-solving skills.
• Ability to effectively communicate with internal teams and external clients.
• Leadership skills with the ability to motivate and develop a team.
• Works well under pressure.

Pay Range

$17.66 - $25.74/hr

Other Information

• Remote role (based out of Greenville, NC)
• Monday - Friday, full-time, day shift
• Great Benefits

General Statement

It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.

ECU Health

About ECU Health

ECU Health is a mission-driven, 1,708-bed academic health care system serving more than 1.4 million people in 29 eastern North Carolina counties. The not-for-profit system is comprised of 13,000 team members, nine hospitals and a physician group that encompasses over 1,100 academic and community providers practicing in over 180 primary and specialty clinics located in more than 130 locations.

The flagship ECU Health Medical Center, a Level I Trauma Center, and ECU Health Maynard Children¿s Hospital serve as the primary teaching hospitals for the Brody School of Medicine at East Carolina University. ECU Health and the Brody School of Medicine share a combined academic mission to improve the health and well-being of eastern North Carolina through patient care, education and research.

Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.

We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant’s qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.