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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates extensive expertise in Hospital Billing and Insurance Follow-Up, with a strong focus on Medicare payer rules, UB04 Facility Pricing, and Reimbursement Analysis. Proficient in utilizing billing systems and advanced analytical skills to resolve complex payment issues and optimize revenue cycle processes.
Highest-signal resume keywords
Hospital Billing ExperienceMedicare Payer KnowledgeUB04 Follow-Up AnalysisAdvanced MS Excel SkillsInsurance Claims Resolution
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Hospital BillingInsurance Follow-UpUB04 Facility PricingReimbursement AnalysisContract AnalysisBilling Regulations ComplianceCash CostingPricing AnalysisCollections ManagementDenial Management
Soft Skills
Problem SolvingAnalytical SkillsOrganizational SkillsDetail-OrientedMentoring
Tools & Technologies
Rubixis AR Follow Up SoftwareEPICParagonZirmed
Certifications & Qualifications
Bachelor's DegreeAssociate Degree
Industry Keywords
Revenue CycleHealthcare ProvidersPayer TypesFee SchedulesReimbursement Procedures
About the role
Key responsibilities & impact- Learn and understand the Rubixis platform and available resources
- Work assigned accounts from start to finish successfully and in a timely manner
- Call healthcare insurance companies, affiliates, and providers to resolve contract or payment issues
- Analyze contract, billing, cash costing, pricing, and collections on accounts in compliance with billing regulations, policies, and procedures
- Investigate insurance payments that deviate from expected payment
- Collaborate with leadership and team members to confirm, challenge, or provide trending and solutions
- Act as a mentor to Rep I and Rep II associates
- Manage moderately complicated insurance denials and underpayments via Rubixis AR Follow Up software
Requirements
What you’ll need- 5+ years Hospital Billing with follow up experience, with advanced knowledge of all payer types
- Knowledge of Medicare payer rules and processes, including interpreting denial reasons, submitting appeals to Medicare payers, and accessing Medicare portals
- Detailed understanding of insurance follow-up for resolving non-paid, denied, under-paid, and rejected claims for healthcare providers
- Experience in UB04 Facility Pricing and Reimbursement variance
- Good understanding of revenue cycle
- Basic understanding of HIT systems like EPIC, Paragon, Zirmed, or other billing systems
- Problem solving / superior analytical skills
- Organized and detail-oriented aptitude
- Bachelor's or Associate degree
- 2+ years of experience in UB-04 Follow-Up and/or Contract/Reimbursement Analysis, including investigation of pricing and reimbursement variances
- Detailed knowledge of Facility Reimbursement contracts, fee schedules, and reimbursement procedures
- Advanced MS Excel skills