Job Summary

 Essential Duties and Responsibilities

These duties and responsibilities described below represent the general tasks performed on a daily basis; other tasks may be assigned.

Submit Inpatient/Outpatient electronic and paper claims (UB-04 and 1500) to the appropriate government and non-government payers. Understand how to resolve Billing errors and/or warnings that are identified in the Patient Accounting and Billing System. Keep abreast of payer-specific and government requirements and regulations. Ensures claim information is complete and accurate in order to accelerate cash collections. Analyze information contained within the Patient Accounting and Billing system to make decisions on how to proceed with the billing of an account. Processes rejections by correcting any billing error and resubmitting claims to government and non-government payers. Place unbillable claims on hold and properly communicate to various Hospital departments the information needed to accurately bill. Process late charge claims in the event that charges are not entered in a timely fashion by Hospital Departments. Submit corrected claims in the event that the original claim information has changed for various reasons. Perform the billing of complex scenarios such as interim, self-audit, combined, and split billing etc. Limit the number of unreleased claims by reviewing all imported claims and either billing or holding the claim for further review. Meet Billing productivity and quality requirements as developed by Leadership. Measured on high production levels, quality of work output, in compliance with established CRH’s policy and standards. Record or generate revenue by gathering and processing information that impacts the patient revenue process. Review patient financial records and/or claims prior to submission to ensure payer-specific requirements are met.

Education and Experience

Minimum Required Education: High school diploma or equivalent

Preferred Education: College courses or associate’s degree

Experience: 3+ years as a Hospital Biller or Follow-up representative preferred