Claims Billing Representative

The Claims Billing Representative is responsible for efficiently processing third-party claims for payment on designated inpatient and outpatient accounts using a computerized editing system, aiming to minimize accounts receivable days. Working under general supervision, this role processes claims, accurately adhering to regulations, policies, and guidelines.

Processes third-party claims for payment on assigned patient accounts promptly and accurately, ensuring that all claims are filed electronically or on paper as required by regulations and policies in order to facilitate timely reimbursement.

Works on all claim-related edits diligently, processing claims accurately to adhere to regulations, policies, and guidelines and verifies charges for accuracy and completeness to maximize reimbursement, including the correct and timely submission of attachments required for claims.

Completes billing claim edits accurately and within a timely manner, ensuring that all claims are billed on a daily basis and maintaining a window of no more than three days to ensure a smooth billing process and minimize delays in claim submissions.

Maintains thorough, concise, and up-to-date documentation, ensuring that all relevant information related to claims processing is well-documented.

Stays up-to-date with changes in healthcare reimbursements, attending seminars and weekly staff meetings to maintain current knowledge.

Performs other duties as assigned.

EDUCATION :

Required : High School Diploma or equivalent

EXPERIENCE : Required : 3 Years

LICENSURE / CERTIFICATION / REGISTRY / LISTING :

Equal Opportunity Employer At Cone Health, we strive to create a welcoming atmosphere that celebrates a diverse and unique workforce. We believe in offering equal opportunities for employment to all applicants and employees, regardless of their race, religion, age, sex, sexual orientation, gender identity, veteran's status, ethnicity, national origin, disability, color, or any other characteristic protected by law. Our hiring and employment choices are based on each individual's qualifications, skills and performance. We believe that by embracing the diversity of our team, we can better serve our patients, communities and each other.