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Billing Services Representative

Saint Peter's Healthcare System Inc

  • Piscataway, NJ
  • 30+ days ago

    Highlights

    Review outstanding accounts using ATB/queues/payments reports/halt report/electronic billing edits/credit balances. Use technology provided (including hospital information system, contract management system, electronic billing system, payer websites and document imaging system.).

    Numbers & Facts

    LocationPiscataway, NJ

    Description

    • 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.

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