Healthcare Billing Specialist – Claims & Rebilling

White Plains Hospital Inc; Des Moines (IA); Remote; USD 38,000 - 57,000; Full time

Job summary

The Patient Accounts Billing Representative at White Plains Hospital Medical Center is responsible for reviewing unbilled claims and bills, ensuring timely billing and claim resolution to expedite payment. This role processes claims in the HIS system, handles re-billing and follow-up on aged accounts to maximize cash flow.

Key duties include applying edits, refunds when needed, and coordinating with third-party payers.

Qualifications

• High School Required.
• 1-3 years Clerical and business aptitude with 1-2 years of Hospital experience required.
• Less than 1 year Medical terminology Preferred.
• Clerical experience required (Medium proficiency).
• Basic Computer skills (Medium proficiency).
• Patient Financial Svcs Spec - HBI Learning Must be completed during onboarding process Upon Hire Required.

Responsibilities

• Understands and adheres to the WPH Performance Standards, Policies and Behaviors.
• Insure adherence to federal and state billing regulations.
• Completes accurate billing to all third-party insurance carriers.
• Monitors host system and biller scrubber to insure timely resolution of unbilled accounts.
• Completes review of third-party trial balance reports within the current month.
• Researches and initiates refunds to patients or insurance carriers as needed.
• Sends inquiries to patients regarding inaccurate or incomplete information.
• Completes charge adjustments and allowances entries on accounts as needed.
• Recodes accounts by insurance carrier and plan number and enters into the HIS for re-billing purposes.
• Processes rejections on third party accounts.
• Reviews mail correspondence and responds accordingly.
• Review on-line billing edits for errors, corrections, or missing information. Enter necessary corrections into HIS.
• Assists with telephone calls as needed.
• Completes rebilling process for late charges daily.
• Monitors host system and bill scrubber for billing delays and to expedite processing.
• Performs all other related duties as assigned

Skills

Clerical experience

Medical terminology (preferred)

Education

High School Diploma

Tools

HIS system

Biller software

Job description

The Patient Accounts Billing Representative at White Plains Hospital Medical Center is responsible for reviewing unbilled claims and bills, ensuring timely billing and claim resolution to expedite payment. This role processes claims in the HIS system, handles re-billing and follow-up on aged accounts to maximize cash flow.

Key duties include applying edits, refunds when needed, and coordinating with third-party payers.