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Billing Specialist Acdm Sr

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Listing Info

Since its founding in 1919, The Methodist Hospital, The Methodist Hospital System's anchor facility, has earned worldwide recognition. The Methodist Hospital is affiliated with the Weill Medical College of Cornell University and NewYork-Presbyterian Hospital, one of the nation's leading centers for medical education and research. Methodist is also affiliated with The Menninger Clinic, a national specialty psychiatric and behavioral hospital, ranked as one of 'America's Best Hospitals.' The Methodist Hospital directs millions of research dollars into patient care and offers the latest innovations in medical, surgical and diagnostic techniques. With 1250 licensed beds, 52 operating rooms and over 5000 employees, The Methodist Hospital offers complete care for patients from around the world.

Job Summary

Responsible for processing all third party claims for inpatient and outpatient primary and secondary claims for professional billing. Heavy collections and accounts follow-up on all outstanding balances.

Duties And Responsibilities

Expedites and maximizes payment of insurance medical claims by contacting third party payors and patients.Review third party payors Aged Trial Balance Report to locate and resolve accounts. Collaborates with management in developing a plan to reduce aging of accounts over 90 days by providing verbal and written communication.

Investigate and appeal unpaid, or partially paid claims by insurance companies.
Resolve denials as they appear.
Review claims to verify payments are made according to fee schedule and contractual adjustments are taken appropriately.
Must meet established follow-up productivity goal of completing 200 claims per week.
Identify claims processing issues and notifying Manger to avoid further delay in claims processing.
Document clear, concise and complete follow up notes in system for each account worked.
Assure accounts are completed and worked at a high level of quality by visually proofreading and monitoring work output."">
High School Diploma or GED; college degree preferred

Education Requirements

High School Diploma or GED; college degree preferred

Experience Requirements

Five years physician billing experience, preferably in a multi-specialty academic physician practice.
In depth knowledge of CPT-4 and ICD-9 coding; CPC preferred.
In depth knowledge of third party payor reimbursement policies and procedures
Proficient in MS Office Suite.
Self pay collections experience

Certificates, Licenses And Registrations Required

None

Special Knowledge, Skills And Abilities Required

Strong customer service, phone and scheduling skills.
Knowledge of insurance requirements for physician visits and procedures.
Knowledge of requirements for non-invasive lab procedures.

Physical Requirements

Extended periods of walking and standing may be required.

Working Environment

Professional Office Environment"">

Professional Office Environment

About The Methodist Hospital System

Based in the Greater Houston area, The Methodist Hospital System is a diverse, inclusive and growing health care system offering a lifetime of meaningful careers within our many facilities. We’re comprised of a nationally recognized academic medical center and four community hospitals with a history of health care innovation. We’re currently ranked in U.S News & World Report’s “America’s Best Hospitals list. For the seventh straight year we have been named to FORTUNE’s list of “100 Best Companies to Work For” and have been ranked the #1 health care organization in Texas.

Make your first day exceptional… at Methodist.