Medical Billing Specialist

Emerus Holdings, Inc.; The Woodlands (TX); On-site; USD 42,000 - 52,000; Full time

Job summary

Emerus Holdings, Inc. in The Woodlands, TX is seeking a detail-oriented Medical Billing Specialist to join our team. You will manage the timely submission of claims to insurance providers and ensure accuracy of patient data.

This role requires UB-04 knowledge, state and federal payer rules, and proficiency with MS Word, Excel and Outlook. You will work closely with billing colleagues to review denials and keep accounts final billed.

Qualifications

• High School Diploma or GED.
• 3+ years medical billing experience.
• Expert knowledge of UB-04/CMS-1450 claim form.
• Knowledge of state and Federal payment laws.
• Experience using a 10-key adding machine.
• Proficiency with Microsoft Office (Word, Excel and Outlook).
• Fluency in English; written and oral communication.

Responsibilities

• Complete daily billing process and ensure successful completion.
• Review and correct all claims returned by the clearinghouse, payer, or from internal edits.
• Follow-up and investigate any billing errors returned from payers. Work with respective team members/supervisors for resolution.
• Suggest billing component changes as necessary for payers.
• Work various reports (discharge not final billed, billing exceptions, etc) to ensure accurate classification of accounts and to ensure that all accounts have been final billed.
• Complete billing requests from team members for submission of claims not received by the payer and corrected claims as identified.
• Review and update demographic/guarantor/insurance data obtained in the registration process as necessary.
• Track claims made by the company to ensure successful transmission and receipt.

Skills

Medical billing

UB-04 CMS-1450

State and Federal payment laws

10-key adding machine

MS Word

MS Excel

MS Outlook

English fluency

Education

High School Diploma or GED

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

About Us

We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes Allegheny Health Network, Ascension, Baptist Health System, Baylor Scott & White Health, ChristianaCare, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS Health, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far beyond the confines of societal norms. We believe that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for all of our Healthcare Pros.

About Us

We are Emerus, the leader in small-format hospitals. We partner with respected and like-minded health systems who share our mission: To provide the care patients need, in the neighborhoods they live, by teams they trust. Our growing number of amazing partners includes Allegheny Health Network, Ascension, Baptist Health System, Baylor Scott & White Health, ChristianaCare, Dignity Health St. Rose Dominican, The Hospitals of Providence, INTEGRIS Health, MultiCare and WellSpan. Our innovative hospitals are fully accredited and provide highly individualized care. Emerus' commitment to patient care extends far beyond the confines of societal norms. We believe that every individual who walks through our doors deserves compassionate, comprehensive care, regardless of their background, identity, or circumstances. We are committed to fostering a work environment focused on teamwork that celebrates diversity, promotes equity and ensures equal access to information, development and opportunity for all of our Healthcare Pros.

Position Overview

The purpose of this position is to complete the timely and accurate submission of claims (i.e. insurance companies, Medicare and Medicaid, employers, individuals, etc.) for health services provided by the company to ensure prompt payment.

Essential Job Functions

• Complete daily billing process and ensure successful completion
• Review and correct all claims returned by the clearinghouse, payer, or from internal edits
• Follow-up and investigate any billing errors returned from payers. Work with respective team members/supervisors for resolution
• Suggest billing component changes as necessary for payers
• Work various reports (discharge not final billed, billing exceptions, etc) to ensure accurate classification of accounts and to ensure that all accounts have been final billed
• Complete billing requests from team members for submission of claims not received by the payer and corrected claims as identifiedReview and update demographic/guarantor/insurance data obtained in the registration process as necessary
• Track claims made by the company to ensure successful transmission and receipt

Other Job Functions

• Attend staff meetings or other company sponsored or mandated meetings as required
• Perform additional duties as assigned
• Willingness and ability to work overtime

Basic Qualifications

• High School Diploma or GED, required
• 3+ years medical billing experience, required
• Expert knowledge of the UB-04/CMS-1450 claim form, required
• Knowledge of state and Federal payment laws, required
• Experience using a 10-key adding machine, required
• Proficiency with Microsoft Office (Microsoft Word, Excel and Outlook), required
• Position requires fluency in English; written and oral communication