Hill-Rom Billing Specialist in St. Paul, Minnesota
The Billing Specialist will coordinate and execute processes of front-end medical billing of commercial insurance and government program claims for our Respiratory Health products. This consists of all billing activities including initial, re-authorization, and purchases across all lines of business (Commercial/Medicare/Medicaid). The position is responsible for ensuring claims practices follow federal and state billing regulations.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Review patient files and supporting documentation for completeness and accuracy. Identify missing / inaccurate information and gather / correct, as necessary in accordance with billing guidelines.
Complete quality review of each patient file to ensure claims are billed accurately and comply with each payer’s rules and regulations.
Generate commercial insurance and government program claims in system and review for accuracy.
Timely processing of claims; includes: EDI submission via clearinghouse, printing of claims, sorting attachments and mailing.
Assist with managing unbillable revenue, rental hold, clearinghouse rejected claims, and other reports daily and provide updates to management as needed.
Reference reimbursement policies/procedures assigned to this role and keep current with changes in billing regulations, insurance specific policies, as well as company policy and procedures.
Identify any areas of opportunity for improved documentation or efficiency in daily work and communicate back to Revenue Cycle Supervisor for purpose of staff professional development and revenue impacts.
Perform other project and duties as assigned.
EDUCATION AND EXPERIENCE:
High school diploma or equivalent required
3 years of experience in a medical related business environment required; associates degree or higher may substitute for 2 years of experience
Experience working with high-dollar DME preferred
Billing database software experience required
Clearinghouse and payer portal experience preferred
QUALIFICATIONS AND SKILLS:
Knowledge of insurance industry and third-party payer processes
Proven data entry skills required
Ability to organize and prioritize workload
Attention to detail and accuracy
Ability to work independently and manage workload
Strong written, verbal, and interpersonal communications
Proficiency in Microsoft Office software
Primary Location: United States-Minnesota-St. Paul
Posting Entity Hillrom
Req ID: 21123996