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Billing Operations Specialist
2 months ago
At Visaya KPO, we are seeking a skilled Billing Specialist to join our team. As a key member of our revenue cycle team, you will be responsible for ensuring accurate and timely billing and claims processing for our clients.
Key Responsibilities:- Verify patient, billing, and claim information for accuracy using various hospital and physician systems.
- Perform compliant primary, secondary, and tertiary billing functions, including electronic, paper, and portal submission to government and commercial payers.
- Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission.
- Respond timely to emails and telephone messages, as appropriate.
- Communicate issues to management, including payer, system, or escalated account issues.
- Participate in meetings and training seminars, as requested.
- Adhere to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
- Enhance billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments.
- Update patient demographics and insurance information in appropriate systems.
- Monitor claims for missing information, authorization, and control numbers.
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
- Secure needed medical documentation required or requested by third-party insurance carriers.
- Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure.
In addition, the successful candidate will utilize provider billing manuals to obtain billing guidelines and requirements, import verification and escalation of import/export files, and resolve and research billing rejections.
