Description
Job Schedule: Full Time
Standard Hours: 40
Job Shift: Shift 1
Shift Details: Work where every moment matters.
Every day, almost 30,000 Hartford HealthCare colleagues come to work with one thing in common: Pride in what we do, knowing every moment matters here. We invite you to become part of Connecticut’s most comprehensive healthcare network.
The creation of the HHC System Support Office recognizes the work of a large and growing group of employees whose responsibilities are continually evolving so that we and our departments now work on behalf of the system as a whole, rather than a single member organization.
With the creation of our new umbrella organization we now have our own identity with a unique payroll, benefits, performance management system, service recognition programs and other common practices across the system.
JOB SUMMARY:
The Biller is responsible to perform all billing processes to ensure timely reimbursements from all carriers. Biller must efficiently and accurately correct and release claims to payers, while adhering to all client, state and federal guidelines.
RESPONSIBILITIES:
- Ensures claims are submitted timely and all filing deadlines are met.
- Reviews and resolves claims that are denied daily for edits in the electronic billing files.
- Categorizes claims for resolution by other areas as determined by departmental procedures.
- Responsible to notify supervisor of electronic claims not received by payers.
- Responsible to contact Clinical department and Medical records in order to obtain information relevant to denied claims, working with Collection Specialists and other resources as determined by departmental procedures.
- Ensures all correspondence, rejected or denied claims is worked within 48 hours of receipt.
- Ensures all primary claims are released or categorized within 24 hours of receipt.
- Ensures all secondary claims are released or categorized within 48 hours of receipt.
- As per governmental or departmental procedures, removes, adds or moves charges on accounts timely and accurately.
- Identifies and correct charging issues to bring resolution to accounts (as determined by departmental procedures)
- Ensures all rejected or denied claims related to billing are worked daily in the electronic billing software, Medicare or other online system, Siemens, or other core system.
- Keying of primary or adjustment claims into payer online systems where appropriate.
- Maintains an active working knowledge of all billing and reimbursement requirements by Payer.
- Ensures productivity standards are met daily, weekly and monthly.
- Responds to intra-departmental and interdepartmental inquiries, correspondence and requests for information by analyzing charges, bill and contracted arrangements and makes appropriate corrections.
- Ensures quality standards are met and proper documentation regarding patient accounting records.
- Maintains awareness of payer regulations, guidelines, state and federal laws relating to billing and collection procedures through updates at unit meetings to ensure accurate and compliant billing processes.
- According to departmental guidelines, investigates and pursues potential or existing billing, charging or claim problems associates with specific accounts, which can be extensive over time, by contact with appropriate third party payers, vendors or patient in order to resolve the problem.
- Identifies and corrects errors in calculation and posting of insurance contractual adjustments to bring resolution to accounts (as determined by departmental procedures.)
- Identifies and corrects errors in write off calculations to bring resolution to accounts (as determined by departmental procedures.)
- Works on special projects as requested
- Performs duties in alignment with HHC pillars of excellence.
Qualifications
QUALIFICATIONS:
- One to two years related experiencer in Insurance Billing, Collections, accounts receivables and/or denials follow up.
- High School graduate or equivalent required, some college preferred.
- Must have knowledge of Medical terminology, Coding terminology (CPT, ICD-9, HCPC) and Insurance Billing/Reimbursement practices.
We take great care of careers.
With locations around the state, Hartford HealthCare offers exciting opportunities for career development and growth. Here, you are part of an organization on the cutting edge – helping to bring new technologies, breakthrough treatments and community education to countless men, women and children. We know that a thriving organization starts with thriving employees-- we provide a competitive benefits program designed to ensure work/life balance. Every moment matters. And this is your moment.