Medicare Biller Collector at Huntsville… · Madison

Overview

• Reviews and audits accounts located in contract denial management system on a daily basis to resolve and maintain collection status on an account prior to escalating to Team Lead for further review.

• Reviews and processes commercial accounts through contract management system.

• Verifies eligibility, corrects and resubmits claim, and files third party insurances as necessary by adding/updating insurance information within the hospital affiliates.

• Utilizes denial management system and responds to requests from insurance carrier for additional information necessary to process claims.

• Analyzes expected reimbursement information contract management system. Utilizes the system/contract foundation to ensure the accounts are properly paid. Reviews EOB’s in contract management system and determines accurate account balance, detailed denial description, and applicable appeal process.

• Identifies and corrects transactions, such as invalid insurance information, incorrect charges, and posting errors, in host system. Posts adjustments in host system.

• Reviews and verifies claim export data in electronic billing, contract/denial management and/or host system.

• Non-Covered Service

• Benefits Exhausted

• Documentation Request

• Information Requested from Member/Beneficiary

• Not Eligible

• Coordination of Benefits/OHI Update

• Work Related Injury/Other TPL Responsible

• Timely Filing

• Claim Deficiency

• Coding/Billing

• Duplicate Claims

• Overlapping Dates of Service/Service Range

• Re-Admission

Qualifications

Minimum Knowledge, Skills and Experience required:

• General application knowledge of EXCEL, WORD, and ACCESS.
• Proven applicable experience working in an environment that utilizes electronic billing, internal report archives, and tools for applicable database management strongly preferred.
• 3 + years working experience of Hospital or Physician office billing and collection processes including producing account appeals with positive outcomes strongly preferred.
• Prefer at least 1 year of supervisory experience strongly preferred.
• Proven applicable experience of preparing complex correspondence to resolve accounts strongly preferred.
• Effective communication skills verbally and written with internal Hospital departments, Physician Offices, Patient, and Insurance payors.
• Must be able to effectively manage a large volume of accounts while maintaining a high accuracy and positive outcomes.

Education:

• High school diploma or GED
• Prefer associates degree from an accredited college with some applicable college courses.
• Prefer applicant with certification in coding, physician office management, or applicable college courses.

About Us

Highlights of our hospitals

Huntsville Hospital was recently namedBest Regional Hospital and #2 in Alabama by U.S. News & World Report. With 971 beds, a specialized Orthopedic & Spine Tower, a Level III Regional Neonatal ICU, and the largest Emergency Department and Level 1 Trauma Center in the state with our own specialized Red Shirt Trauma Program, there are many opportunities to apply your knowledge and skills. We are a certified Primary Stroke Center and named "One of the Top 100 Hospitals in the Nation with Great Heart Programs." From six cath labs and four EP labs to multiple medical and step-down units, you can continually grow your skillset! We offer a training center on campus for continuing education, Shared Governance Program, Clinical Ladder for professional development, The Daisy Award, and if you are a new grad, a Nurse Residency Program to help you transition from student to professional nurse. We care about you and your well-being by offering an excellent benefits package, childcare, health and wellness programs, an onsite employee pharmacy, a free health clinic, tuition assistance, and much more. We are committed to creating a diverse environment and proud to be an equal opportunity employer. We are a partner to the U.S. Army’s Partnership for Your Success (PaYS) program. Ask us about incentives and additional opportunities.

Huntsville Hospital Benefits:

We are committed to providing competitive benefits. Our benefits package for eligible employees includes medical, dental, vision, life insurance, flexible spending; short term and long term disability; several retirement account options with 401K organization match; nurse residency program; tuition assistance; student loan reimbursement; On-site training and education opportunities; Employee Discounts to phone providers, local restaurants, tickets to shows, apartment application and much more!

Learn more about Huntsville Hospital Health System:

• Careers: https://careers.hhsys.org/careers-home
• Benefits: https://careers.hhsys.org/us/en/benefits
• Education & Professional Development: https://www.huntsvillehospital.org/education
• Life In Huntsville: https://www.huntsvillehospital.org/about-huntsville-al