Hospital Billing Specialist

Position Overview:

Reporting to the Billing Manager, Hospital Billing Specialists are responsible for the daily entry of charges for their assigned surgical centers. This will include but is not limited to the following: perform complete chart reviews, verify patient demographics, assign modifiers, diagnosis codes, and revenue codes in accordance with coding and reimbursement guidelines resulting in claim reimbursement.

Responsibilities:

• Pull any preoperative notes from the designated transcription company.

• Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry.

• Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submission

• Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.

• Execute the recurring billing workflow and generate and transmit claims daily.

• Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).

• Reconcile revenue and billing during the period-end close process.

• Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.

• Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.

• Maintain current knowledge of health care billing laws, rules and regulations and developments

Required Experience:

Requirements:

• Experience in DDE system and Ability Ease

• 3-4 years previous billing experience, with emphasis on Medicare billing

• Preference shown to previous experience in a Facility setting

• Ability to work independently

• Excellent communication skills and interpersonal skills

• Skilled in time management and prioritization of emergent situations

• Comfortable utilizing critical thinking skills

• Proficient with Microsoft Office products

• Experience with electronic patient information systems

• Function as a subject matter expert (SME) for Medicare

Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.

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