Billing Representative, Physician Billing Office (Newtown Square, PA)

Main Line Health, Inc. Philadelphia , PA 19107

Posted 3 days ago

Main Line HealthCare, with over 11,000 employees and 2000 physician practices, is suburban Philadelphia's most comprehensive health care resource, offering a full range of medical, surgical, obstetric, pediatric, psychiatric and emergency services. We are composed of five hospitals, a medical research institute, Main Line HealthCare physician practices and other specialized facilities and services. Main Line Health is committed to the highest standards of patient care and safety, education and research.

Why Work for Main Line HealthCare?

Main Line HealthCare is the rapidly growing multispecialty physician network of Main Line Health including more than 390 community and hospital-based physicians spanning over 32 clinical specialties and subspecialties, with 88 offices located throughout the area including suburban Philadelphia. Main Line HealthCare strives to be the destination of choice for patients, physicians, and health care professionals. We have made it our mission to provide patients with a superior patient experience. This translates to the consistent delivery of safe, high quality clinical care in the absence of preventable harm

Turn your job into a career by joining Main Line Health!

We have a new position for a Billing Representative with Main Line HealthCare's Corporate Billing Office (CBO) located in Newtown Square, PA.

The Billing Representative works with Management and Billing lead to ensure that third party payer claims are billed via the Epic Resolute module in an accurate and timely manner. This is a Full Time, Day shift position.

Responsibilities to include:

  • Responsible for the review and resolution of daily system edits and clearinghouse edits

  • Resolve CBO Charge Review and Claim edits in a timely and efficient manner

  • Meet monthly productivity measures as set by Billing Manager.

  • Using Epic Resolute Claims workqueue processing, prepare and submit insurance claims with all required documentation through electronic and/or manual processes in accordance with MLH/MLHC guidelines and policies.

  • Actively participate in regularly scheduled department meetings

  • Provide insight into daily work responsibilities and current trends/issues to both Billing Lead and Manager.

  • Report any filing issues in a timely manner to Billing Lead

  • Report any problematic workflows and develop workarounds for possible resolution

  • Provide information regarding needed updates to Epic Charge Review and Claim Edit rules for Management revision.

  • Remain up to date on departmental procedures, payer contracts and insurance billing regulations.

  • Monitors timely claims submission.

  • Takes appropriate corrective action to quickly resolve claims issues/edits.

  • Communicates issues to Billing Manager

  • Document all actions in Epic system

  • Other duties as assigned by Management

Qualifications:

Education:

  • High School Diploma or equivalent required

Licensures & Certifications:

  • Certified Revenue Cycle Specialist (CRCS)/American Association of Healthcare Administrative Management (AAHAM), or Certified Revenue Cycle Representative (CRCR)/Healthcare Financial Management Association desirable

Experience:

  • 1-2 years healthcare billing experience and/or accounts receivable experience utilizing automated patient accounting systems (Epic Resolute desirable) preferred.

  • Microsoft Office applications experience. Intermediate Excel proficiency required.

  • Knowledge of insurance contracts, billing regulations and medical terminology preferred.

  • Knowledge of HCPCS/CPT/ICD-10 and revenue codes preferred.

  • Good written/oral communications and problem solving skills required.

  • Strong analytical, mathematical and organizational skills required.

We offer competitive compensation and outstanding comprehensive benefits including tuition reimbursement, 403B matching savings plan, a pension plan, and a generous paid time off program. To be considered, please apply online with your resume at https://www.mainlinehealth.org/careers Enter Job ID45885 in Keyword search box.

Applicants must certify that they have not used tobacco products or nicotine in any form in the 90-days prior to submitting an application to Main Line Health. This will be verified during pre-employment testing. We are an Equal Opportunity Employer. Please, no agency calls.

'114780


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Billing Representative, Physician Billing Office (Newtown Square, PA)

Main Line Health, Inc.