Ashe Memorial Hospital
Billing Specialist (FT)
Ashe Memorial Hospital, Jefferson, North Carolina, United States, 28640
Job Description
Job Description Salary: Pay commensurate with experience At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care ."
Ashe Memorial Hospital is proud to be Voted Ashe's Best Place to Work 2022, 2023, & 2024! Come be a part of our dynamic team; you'll join Ashe's 2022 & 2023 Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice! This is your opportunity to make a large difference in a small community!
Hours: 1st shift, Mon-Fri | No Supervisory Responsibilities | No Travel | Pay commensurate with experience Full time, day shift in Patient Accounting.
JOB SUMMARY: The Billing Specialist is responsible for the accurate and timely preparation, submission, and follow-up of electronic and paper medical claims to third-party payers. This role ensures compliance with payer-specific requirements and federal/state regulations, resolves claim edits and supports the revenue cycle team in achieving optimal reimbursement. The Billing Specialist is responsible for reviewing and resolving clearinghouse hold, error, and rejection lists. The Billing Specialist files primary, secondary, and tertiary insurance, rebills, and reviews payment remittances. Reviews claim rejections for possible correction and provide feedback to the appropriate department. Must be proficient in the use of multiple payor software systems and possess knowledge of billing coding, including CPT, ICD10, HCPCS, modifiers, CCI edits, MUE edits, and claims formats. The ultimate result of these efforts should facilitate complete and prompt payments from third party payors to ensure maximum cash flow. Interacts with patients and staff in a professional manner, promotes teamwork, and creates an environment where a positive patient experience is a requirement.
MINIMUM JOB QUAILIFICATIONS
EDUCATION: High school diploma or general education degree (GED) required. Post high school courses in insurance billing, data processing, and medical terminology preferred.
EXPERIENCE:
1 year of experience in computerized third-party billing of facility and/or professional services required. Knowledge of third-party billing requirements required. 2 years of previous hospital business office experience preferred. 1 year of experience with Meditech and/or SSI preferred.
License/Certifications:
N/A
ESSENTIAL FUNCTIONS: Prepare and submit clean claims electronically and via paper for assigned payers. Review claims for accuracy, completeness, and compliance with payer guidelines. Apply appropriate coding edits (CCI, payer-specific) and modifiers. Correct and resubmit rejected or denied claims. Correct and validate submission of claims to Medicare (DDE). Respond to internal and external inquiries regarding billing and claims. Ensure compliance with HIPAA, CMS, and payer-specific billing regulations. Stay current with changes in billing rules, payer policies, and coding updates.
Must be willing to receive all required vaccinations (i.e., flu shot, etc.).
All new employees working must be fully vaccinated as a condition of employment (unless the new hire has requested and received an exemption). Candidates for employment will be notified of this policy requirement prior to the start of employment. After receiving an offer of employment, new employees must provide proof of vaccination or request and receive an exemption before beginning work.
To apply, please fill out an application, attach a cover letter, and resume. Include gaps in employment and reasons for separation. Criminal background check and pre-employment drug screen required upon conditional job offer.
***Benefits apply the 1st of the month following employment, per policy.*** *For full job description and benefits, please contact Human Resources.
Ashe Memorial Hospital is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care. Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information, or any other classification protected by law. All employment requirements mandated by local, state, and federal regulations will be observed.
Job Description Salary: Pay commensurate with experience At Ashe Memorial Hospital, we are driven by our Mission Statement, "To meet the needs of the community by delivering patient-centered, high quality health care ."
Ashe Memorial Hospital is proud to be Voted Ashe's Best Place to Work 2022, 2023, & 2024! Come be a part of our dynamic team; you'll join Ashe's 2022 & 2023 Best Hospital, Best Surgeon, Best Physician, Best Nurse, and Best Medical Practice! This is your opportunity to make a large difference in a small community!
Hours: 1st shift, Mon-Fri | No Supervisory Responsibilities | No Travel | Pay commensurate with experience Full time, day shift in Patient Accounting.
JOB SUMMARY: The Billing Specialist is responsible for the accurate and timely preparation, submission, and follow-up of electronic and paper medical claims to third-party payers. This role ensures compliance with payer-specific requirements and federal/state regulations, resolves claim edits and supports the revenue cycle team in achieving optimal reimbursement. The Billing Specialist is responsible for reviewing and resolving clearinghouse hold, error, and rejection lists. The Billing Specialist files primary, secondary, and tertiary insurance, rebills, and reviews payment remittances. Reviews claim rejections for possible correction and provide feedback to the appropriate department. Must be proficient in the use of multiple payor software systems and possess knowledge of billing coding, including CPT, ICD10, HCPCS, modifiers, CCI edits, MUE edits, and claims formats. The ultimate result of these efforts should facilitate complete and prompt payments from third party payors to ensure maximum cash flow. Interacts with patients and staff in a professional manner, promotes teamwork, and creates an environment where a positive patient experience is a requirement.
MINIMUM JOB QUAILIFICATIONS
EDUCATION: High school diploma or general education degree (GED) required. Post high school courses in insurance billing, data processing, and medical terminology preferred.
EXPERIENCE:
1 year of experience in computerized third-party billing of facility and/or professional services required. Knowledge of third-party billing requirements required. 2 years of previous hospital business office experience preferred. 1 year of experience with Meditech and/or SSI preferred.
License/Certifications:
N/A
ESSENTIAL FUNCTIONS: Prepare and submit clean claims electronically and via paper for assigned payers. Review claims for accuracy, completeness, and compliance with payer guidelines. Apply appropriate coding edits (CCI, payer-specific) and modifiers. Correct and resubmit rejected or denied claims. Correct and validate submission of claims to Medicare (DDE). Respond to internal and external inquiries regarding billing and claims. Ensure compliance with HIPAA, CMS, and payer-specific billing regulations. Stay current with changes in billing rules, payer policies, and coding updates.
Must be willing to receive all required vaccinations (i.e., flu shot, etc.).
All new employees working must be fully vaccinated as a condition of employment (unless the new hire has requested and received an exemption). Candidates for employment will be notified of this policy requirement prior to the start of employment. After receiving an offer of employment, new employees must provide proof of vaccination or request and receive an exemption before beginning work.
To apply, please fill out an application, attach a cover letter, and resume. Include gaps in employment and reasons for separation. Criminal background check and pre-employment drug screen required upon conditional job offer.
***Benefits apply the 1st of the month following employment, per policy.*** *For full job description and benefits, please contact Human Resources.
Ashe Memorial Hospital is an equal opportunity employer and, as such, considers individuals for employment according to their abilities and performance. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the position without compromising patient care. Employment decisions are made without regard to race, age, religion, color, sex, national origin, physical or mental disability, marital or veteran status, sexual orientation, genetic information, or any other classification protected by law. All employment requirements mandated by local, state, and federal regulations will be observed.