Work Shift:

Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advance technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.

Position Overview:

Implant/Trailer Billing Rep

JOB CODE:50360

SUMMARY (BASIC PURPOSE OF THE JOB)Prepares and submits claims and responds to routine inquiries regarding claims. Contacts payors regarding status of outstanding claims. Documents all correspondence, payments and adjustments into the patient account record via patient accounts system.MINIMUM REQUIREMENTS

Education: High school diploma or equivalency.

Experience: One year billing experience in a healthcare environment.

Other Credentials:

Knowledge and Skills: Ability to navigate through multiple systems. Excellent communication and interpersonal skills. Requires typing skills and data entry skills with emphasis on accuracy. Knowledge and ability to interpret payor contracts preferred.

Special Training: Working knowledge of Microsoft office.

Mental, Behavioral and Emotional Abilities:

Usual Work Day:8 Hours  

ESSENTIAL FUNCTIONSReviews appropriate documents. Interprets information and follows appropriate federal, state, third party and departmental guidelines to prepare bills to carriers. Complies with implant and trailer billing procedures, as required by the hospital's managed care contracts.Identifies and bills all implant or trailer services as outlined by work lists, management and hospital managed care contracts through access to multiple systems.Gathers and communicates information from third party payors to expedite payment on outstanding accounts.Stays current with the latest updates for third party, collection, and bad-debt regulations by reading bulletins and other memoranda. Participates in annual training sessions as required.Sets goals to resolve any outstanding issues with third party representatives.Evaluates, reviews, and analyzes patient accounts to determine if correct third party payments have been received and recorded. Ensures compliance with contract terms. Follow up with the payors regarding non-payment or any discrepancy in payments received.Prioritizes and updates files and other required documentation in accordance with established policies, guidelines, and procedures.Reviews and stays current with assigned work lists daily.Operates computer software efficiently to complete required billing and follow-up tasks.Performs other duties as assigned and adapts to changing departmental demands.PHYSICAL DEMANDS AND WORK ENVIRONMENT

Frequent physical demands include: Standing , Walking

Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion

Continuous physical demands include: Sitting

Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs.

Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing

Anticipated Occupational Exposure Risks Include the following: N/A

Offers are contingent upon successful completion of our onboarding process and pre-employment physical.  Capital Health will require all applicants (including contractors, travelers and consultants) to have an annual flu vaccine prior to start date, with the exception of individuals with medical and religious exemptions.

"Company will never ask candidates for social security numbers or date of birth during application phase. If you are asked for this information online, you may be a target for identity theft."