The responsibilities of the Billing Representative I are to accurately post remittance advices, identify and track payment inconsistencies and to complete and document monthly audit requirements of contracted health plans.
Essential Duties and Responsibilities:
- Accurately post health plan payments and reconcile daily.
- Accurately assign denial codes.
- Understand contractual expectations with health plans to identify and report payment inconsistencies.
- Perform and document post trip audits specified by contracted health plans.
- Responds to daily inbound/outbound telephone calls to facilitate explanation of co-payment balances due.
- Identify any inconsistent billing practice or methodology for further review. Forward identified transports to audit area for further investigation.
- Complete claim reprocessing projects as advised by Supervisor.
- Provide various support services within the billing department.
- Maintain confidentiality at all times whether in reference to confidential information or as it relates to medical information for specific patients.
- Communicate effectively and professionally with external customers.
- Meet daily productivity quotas on a consistent basis.
- Adhere to all company policies and procedures.
Non-Essential Duties and Responsibilities:
- Perform other duties as assigned.
- High School Diploma or GED.
- Demonstrated familiarity with medical terminology and services.
- Previous experience in healthcare setting preferred.
- 0-2 year’s data entry.
Other i.e. knowledge and skills:
- Must be proficient with Microsoft Office software.
- Must type 30 wpm.
- Must operate 10-key calculator by touch.
- Must have effective oral, written and interpersonal communication skills.