Hospital Billing Representative II
Job Description
Do you want to work at one of the Top 100 Hospitals in the nation? We are guided by our values of Love and Excellence and are passionate about delivering health, not just health care. Come join us at ChristianaCare!
ChristianaCare, with Hospitals in Wilmington and Newark, DE, as well as Elkton, MD, is one of the largest health care providers in the Mid-Atlantic Region. Named one of “America’s Best Hospitals” by U.S. News & World Report, we have an excess of 1,100 beds between our hospitals and are committed to providing the best patient care in the region. We are proud to that Christiana Hospital, Wilmington Hospital, our Ambulatory Services, and HomeHealth have all received ANCC Magnet Recognition®.
PRIMARY FUNCTION:
Collection of insurance accounts receivable including, but not limited to, reporting, analysis, disputes, appeals, and reconciliation of acute hospital/facility claims.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Reviews and submits UB-04 forms to insurance companies.
Performs follow-up with insurance representatives to obtain claim status, payment and to resolve claim discrepancies.
Submits itemized bills, medical records and corrected claims as needed.
Reviews payment vouchers to ensure proper reimbursement.
Interacts directly with department staff, Revenue Integrity, HIMS, and payer representatives to evaluate and resolve line level denials.
Provides trend analysis to management, leadership, and insurance liaisons.
Writes and submits appeals when claims deny incorrectly.
Works rejection and late charge reports.
Utilizes the Soarian/Cerner billing system for AR and denial reporting.
Utilizes ePremis for clean claim review and transmission.
Accesses external payer sites for payer policies and claim disputes.
Performs other related duties as required.
SCOPE, PURPOSE, AND FREQUENCY OF CONTACTS:
Frequent contact with hospital billing staff, Revenue Integrity, HIMS, Admitting, ancillary department contacts and insurance representatives.
EDUCATION AND EXPERIENCE REQUIREMENTS:
High school graduate or equivalent required, Associate’s Degree preferred.
1-3 years of experience in A/R processes preferred, ideally within a hospital billing setting.
Demonstrated strong verbal and written communication skills.
Strong organizational and communication skills.
Ability to multi-task, self-direct, work independently and with team and team leads.
Soarian, Power Chart, and ePremis experience preferred.
KNOWLEDGE, SKILL, AND ABILITY REQUIREMENTS:
Data entry; Soarian and ePremis navigation.
Working knowledge of Microsoft applications, such as Word and Excel.
Knowledge of hospital billing and reimbursement policies and procedures.
Skill in written and oral communication.
Ability to act independently within established guidelines.
Ability to multitask, prioritize and manage high volume tasks.
Ability to exercise judgement and tact.
Christiana Care Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.
EEO Statement: ChristianaCare Health System is an equal opportunity employer, firmly committed to prohibiting discrimination, whose staff is reflective of its community, and considers qualified applicants for open positions without regard to race, color, sex, religion, national origin, sexual orientation, genetic information, gender identity or expression, age, veteran status, disability, pregnancy, citizenship status, or any other characteristic protected under applicable federal, state, or local law.
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