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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in medical billing and collections, including knowledge of ICD-10, CPT, HCPCS, and NCCI coding systems. Proficient in utilizing hospital systems for accurate patient and billing information management while adhering to compliance standards and regulations.
Highest-signal resume keywords
Medical Billing ExperienceICD-10 KnowledgeCPT KnowledgeHealth Information Systems ProficiencyPatient Accounting Systems Knowledge
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 CollectionsBilling ComplianceClaim EditingThird-Party Billing GuidelinesBilling Claim Forms KnowledgePayor Contracts KnowledgeTimely Filing DeadlinesAuthorization MonitoringConfidentiality MaintenanceDocumentation Securing
Soft Skills
Effective CommunicationTimely ResponseProblem-SolvingTeam ParticipationAttention to Detail
Tools & Technologies
Microsoft WordMicrosoft ExcelEMR SystemsClaim ScrubbersPatient Accounting SystemsEPICCernerSTARMeditechDDE Medicare Claim System
Industry Keywords
JCAHO StandardsFederal RegulationsState RegulationsLocal RegulationsInsurance Collection Guidelines
Tech Stack
Tools & technologiesInvision
About the role
Key responsibilities & impact- Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
- Perform compliant primary/secondary, tertiary and rebill billing functions, including electronic, paper and portal submission to payers
- Edit claims to meet billing compliance guidelines for electronic and hardcopy submission
- Respond timely to emails and telephone messages
- Communicate issues to management, including payer, system or escalated account issues
- Participate in meetings, training seminars and in-services to develop job knowledge
- Adhere to professional standards, hospital policies and procedures, federal, state and local requirements, and JCAHO standards
- Update patient demographics and insurance information in appropriate systems
- Monitor claims for missing information, authorization, and control numbers (ICN/DCN)
- Follow guidelines for prioritization, timely filing deadlines, and notation protocols
- Secure medical documentation required or requested by third-party insurance carriers
- Maintain confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
- Perform other related duties as required
Requirements
What you’ll need- 1-2 years of medical collections/billing experience
- Basic knowledge of ICD-10, CPT, HCPCS and NCCI
- Basic knowledge of third-party billing guidelines
- Basic knowledge of billing claim forms (UB04/1500)
- Basic knowledge of payor contracts
- Working Knowledge of Microsoft Word and Excel
- Basic working knowledge of health information systems (i.e. EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
- Working knowledge of one or more of the following patient accounting systems: EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts or Paragon
- Working knowledge of DDE Medicare claim system
