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Billing Representative
Munson Healthcare. Exercise a high degree of control over confidential medical information .
Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing processes, including third-party payer reimbursement and compliance with hospital reimbursement contracts. Proficient in managing confidential medical information while effectively resolving payment inquiries and maintaining accurate billing records.
Highest-signal resume keywords
Third-Party Payer ReimbursementHospital Billing ExperienceElectronic Billing TransmissionProblem-Solving AbilityCustomer Service Experience
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
Medical BillingClaims ProcessingReimbursement AnalysisAuditing ChargesPower Chart ProficiencyCoordination-of-Benefits Claims3M CCI Edits KnowledgeCredit ReportingInsurance VerificationBilling Documentation
Soft Skills
Strong Problem-Solving AbilityEffective CommunicationTeam CollaborationAttention to DetailTime Management
Tools & Technologies
Power ChartElectronic Billing Systems
Certifications & Qualifications
High School Diploma or GEDVaccination for Measles, Mumps, Rubella and VaricellaFlu Vaccine Compliance
Industry Keywords
Healthcare BillingPatient ClaimsInsurance PayersRural Health BillingNo-Fault Rules
About the role
Key responsibilities & impact- Exercise a high degree of control over confidential medical information
- Establish priorities and meet deadlines using strong problem-solving ability
- Keep current with changing billing requirements and share pertinent information with billing team members
- Follow the daily priority matrix on assigned tasks
- Complete electronic billing transmission for current claims
- Prepare and mail hard copy claims to insurance companies, patients, and other responsible parties
- Follow up on unpaid claims every 30 days after the initial 45/60-day processing period
- Review and document procedures as appropriate
- Review rejections for third-party payer compliance and escalate concerns to management
- Produce quarterly credit reports as required by Medicare
- Report credit balances to insurance payers and process them according to payer requirements within 30 days
- Demonstrate understanding of hospital reimbursement contracts
- Determine whether payments comply with third-party payer reimbursement requirements
- Process coordination-of-benefits claims in compliance with no-fault rules, regulations, and payer guidelines
- Analyze patient claims and initiate corrective action, including auditing charges, 72/24-hour requirements, payments, and contractual agreements
- Resolve payment questions with insurance companies
- Verify insurance benefits on problem accounts and assist patients with MSP/COB issues
- Review Power Chart records to confirm services are separate and distinct when multiple charges are added to an account
- Apply working knowledge of 3M CCI edits
- Use Power Chart to collect and print records for hard copy Auto Accident and Workers’ Comp claims
- Provide billing services for multiple facilities as needed
- Report to the financial class billing coordinator and support the team structure
Requirements
What you’ll need- High school diploma or GED is required
- Two years of related work experience in customer service, healthcare or business field required
- Knowledge of third-party payer reimbursement required
- Associate degree preferred
- Hospital billing experience (Rural health) preferred
- Must be vaccinated or have lab confirmed immunity for Measles, Mumps, Rubella and Varicella
- Must receive a flu vaccine during the flu season in the year hired and annually thereafter, or receive an approved medical or religious exemption
Benefits
Comp & perks- Tuition reimbursement
- In-person and online development
- Access to career hub
- Full benefits
- Paid holidays
- Generous PTO
- Employee discounts
- Free individual retirement counseling
- Free wellness platform for you and your family
- Personalized support for personal or family challenges
- Employee participation in improvement huddles, employee surveys, and town hall meetings