Hospital Billing Job Description
Hospital billing
provides training to healthcare professionals, coders, and Revenue Cycle staff in ICD, CPT, HCPCS Level II coding guidelines, proper documentation guidelines and other information related to coding.
Hospital Billing Duties & Responsibilities
To write an effective hospital billing job description, begin by listing detailed duties, responsibilities and expectations. We have included hospital billing job description templates that you can modify and use.
Sample responsibilities for this position include:
Promotes and maintains Revenue Cycle Integration and claims standards for HB
Have accountability for the oversee of day-to-day operational activities, accurately assess the workload and deploy available team resources optimally, maintain compliance and quality standards and ensure timely billing and collection of receivables to avoid loss of revenue
Customer Support- Interacts with customers in a timely manner
Works all identified insurance requirement edits through the electronic billing system
Communicates issues with patient access and facility departments
Researches required information and maintains pending follow up on a daily/weekly basis
Manages and maintains the billing processes and programs to provide effective electronic filing strategies
Provides ongoing training and education to billing staff to ensure that policies and procedures are followed
Meets with the Billing Manager regularly to effectively communicate and resolve billing issues, set and prioritize goals, improve processes and review insurance and billing status
Retrieves and maintains electronic filing and edit reports
Hospital Billing Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Hospital Billing
List any licenses or certifications required by the position: CPC, HB, HSHS, SBO, EPIC, COC, ARCR
Education for Hospital Billing
Typically a job would require a certain level of education.
Employers hiring for the hospital billing job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Associate Degree in Education, Business, Healthcare, Computer Science, Associates, Business/Administration, Information Systems, Health Care, Health, Accounting
Skills for Hospital Billing
Desired skills for hospital billing include:
CPT and ICD-10 codes
Reimbursement of health care accounts
Revenue
Complex systems issues
Healthcare issues
Software design and integration
Software functionality
Current healthcare environment
CPT
Current functionality of the patient accounting systems
Desired experience for hospital billing includes:
Researches and corrects claim submission reports
Assures that all provider enrollments are timely and accurate for all carriers
Manages, edits and provides monthly edit statistics
Assists with training of Billing personnel in electronic filing and data entry methods
Sees that patient billing submission is efficient and organizes the billing schedule
Resolves claim edits based on documented processes in the electronic billing system
Hospital Billing Examples
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Hospital Billing Job Description
Job Description Example
Our company is growing rapidly and is looking for a hospital billing. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for hospital billing
- Reviews unreleased claims daily in order to resolve and release to the payer
- Resolves requests in all designated billing queues in eRequest and CRT daily
- Completes secondary claim releases daily
- Documents Artiva collection system, eRequest communication system or Relay Assurance billing system related to activities completed for claim release
- Assist patients regarding billing issues as needed
- Resolve accounts receivable aging to secure constant cash flow
- Serve as the primary billing office contact to discuss and resolve issues with charging departments in the ministries, HIM, and physician offices (customers)
- Serve as a resource for Accounts Receivable (AR) Specialists when issues need to be escalated that involve resolution with customers
- Ensure appropriate use of adjustment codes and activity codes to allow for appropriate workflow and trending
- Proactively identify opportunities to improve business results and/or to alert business units of trends, anomalies or health plan rules and decisions that need attention
Qualifications for hospital billing
- Analyze and document client's business requirements and processes
- Decompose information gathered into details including sources of data, data types, users, user types
- Prior Medicaid followup experience
- Escalate unresolved issues appropriately and recommend solutions to minimize future problems
- Must meet primary productivity and performance standards
- Make appropriate decisions on account activity consistent with approved authority levels
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Hospital Billing Job Description
Job Description Example
Our growing company is searching for experienced candidates for the position of hospital billing. Please review the list of responsibilities and qualifications. While this is our ideal list, we will consider candidates that do not necessarily have all of the qualifications, but have sufficient experience and talent.
Responsibilities for hospital billing
- Be accountable for working accounts receivables for commercial or regulatory accounts, and/or for follow up or denials for patient accounts
- Serve as a role model for the values and mission of the organization
- Act as a backup for other Application Support team members and functions, as needed
- Assesses functionality within new application releases to determine operational and system impact
- Support day to day maintenance of HB system
- Anticipates and provides solutions to complex problems with the necessary priorities
- Utilize Epic to review and satisfy billing edits, charge information, private or government insurance benefits, and other related information from multiple billing and documentation servers (for multiple hospitals, clinics and insurance companies) while resolving account balances and removing barriers to cash flow
- Escalate unresolved issues appropriately, quickly and recommend solutions to minimize future problems
- Must be able to meet primary productivity and performance standards
- Report to the A/R Manager and aid in development of annual A/R goals
Qualifications for hospital billing
- Minimum of 6 months of experience in automated, computerized account follow-up system
- Prior Medicare Follow-up experience for OR & CA
- Make task assignments for HB Team ensuring deadlines are met and proper processes are followed and documented in accordance to NYC HHC Implementation standards
- 4 or more years industry related experience in a healthcare or information services setting with IS or operational healthcare billing experience with a technical aptitude in a hospital setting
- Three (3) years of experience coding in professional coding in a large hospital or academic setting
- Experience in understanding and usage of computers, including the Microsoft Office Suite and preferably knowledge of billing/collections software, the ability to learn applications relevant to the position, required
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Hospital Billing Job Description
Job Description Example
Our company is looking to fill the role of hospital billing. If you are looking for an exciting place to work, please take a look at the list of qualifications below.
Responsibilities for hospital billing
- Prepares scripts and materials performing unit, system and integrated testing tasks
- Reviews OR documentation for completeness and interacts with clinical staff and management for clarification
- Transposes data from OR documentation to billing system
- Enters charges by exception from preference card and specialty charge sheets
- Reconciles billing errors and provides support for systems maintenance/trouble-shooting and report writing
- Assists in managing the needs of the waiting room
- Assists in scheduling faxed surgical procedures and in the verification of surgery schedule
- Assists with answering phones
- Supports change initiatives
- Ensure the timely and effective conduct of audits in accordance with departmental standards
Qualifications for hospital billing
- Resolute Hospital Billing Admin with SBO certification
- Minimum of 5 years of hands on Epic implementation experience
- Experience with multiple implementations is a plus
- 2 years of healthcare account management experience in health insurance claims processing or medical office
- 2 years of healthcare account management experience in a hospital setting
- Supports business/clinical operations with clinical and financial end users
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Hospital Billing Job Description
Job Description Example
Our innovative and growing company is looking for a hospital billing. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for hospital billing
- Assist in the development of written policy and procedure for key institutional risk areas
- Identify physician and hospital billing risk areas for which institutional policy would be appropriate
- Notifies payors of changes relating to providers (address changes, terminations, panel status)
- Organizes and maintains files on providers
- Prepares bills in the paper and/or electronic format designated by departmental and payor guidelines
- Reviews bills for accuracy, including proper diagnosis and procedure codes
- Documents billing activities in patient account records
- Prepares and reviews routine billing reports to ensure timely and accurate billing activity
- Participates in workflow design and understand how the system will impact end users
- Monitor claims payments for contract compliance
Qualifications for hospital billing
- RN with 5-10 years healthcare experience or Medical Record coder with 5-10 years hospital coding experience with certification
- Minimum Intermediate skills with Microsoft Access, Word, and PowerPoint
- Minimum of six years in programming and systems analysis within health care systems administration, financial and/or clinical systems support and maintenance general knowledge of major health care information issues
- Previous medical billing experience (hospital, professional, DME, chiropractic, etc) strongly preferred
- Knowledge of all types of insurance plans
- The employment of the candidate hired for this position will be contingent on their agreement to complete the appropriate Epic module training and certification within a reasonable period of time as required for the position
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Hospital Billing Job Description
Job Description Example
Our company is growing rapidly and is hiring for a hospital billing. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for hospital billing
- Work with payers to obtain accurate reimbursement and to help identify and correct fee schedule load errors or misinterpretations
- Provide timely, pertinent and accurate information to management for decision making and to payers for reimbursement corrections and resolutions under the direct supervision of the Manager, Payer Relations & Payer Integrity
- Serve as the primary department contact with customers (charging departments, HIM coding, or physician offices)
- Review insurance plan guidelines against the patient account and records to determine issues that delay claim from processing correctly
- Review requests regarding billing edits with input from customers
- Review escalated requests from AR Specialist, makes account corrections, or obtains input from customers for instructions to the AR Specialist
- Process charge credits and debits
- Evaluate late charges (adjustments vs billing)
- Research patient inquiries regarding services by confirming charges via medical records or direct contact with applicable customer
- Perform audits and address outcomes as appropriate, monitor the A/R and ensure that key performance metrics are met
Qualifications for hospital billing
- Prior experience with Epic is preferred
- Strong knowledge/experience in hospital billing workflows and processes is required
- Minimum Three experience as systems analyst, application specialist or equivalent business experience, preferred
- Successful involvement in re-engineering and implementing process improvement
- Basic working knowledge of key areas of the healthcare billing business
- Significant and successful project management exposure