Community Health Systems Unbilled Specialist in Brentwood, Tennessee

Description:

The Unbilled Specialist is responsible for researchingunbilled issues to produce the bill to the insurance company expeditiously. Theposition is required to identify and resolve complex unbilled claims issues andworking with all departments of the hospital in unbilled error resolution.

DUTIES AND RESPONSIBILITIES:

  • Research unbilled issues to optimize the billing cycle andreduce elapsedbilling days

  • Analyzes the daily Unbilled report and the denial worklistto bill charges timely as well as identify trends to avoid future billingdelays and denials.

  • Create weekly unbilled reports for hospital and QHCcorporate management teams.

  • Researches, identifies and corrects billing errors andcommunicates findings to the hospitals management teams.

  • Attends unbilled calls with the QHC billing teams andhospitals

  • Prepares and maintains sufficient supporting documentationfor all billing corrections.

  • Corrects errors in order for the billers to resubmit billsto Third Party Payers.

  • Serves as the unbilled liaison between Patient FinancialServices and HIM and other clinical departments.

  • Audits each bill for charges, duplications and overlappedaccounts before billing, making any necessary adjustments and documentingappropriately. Maintains and secures medical documentations to support claimsor appeals as necessary.

  • Identifies additional billing edits required to submit cleanand compliant billing to various payers.

  • Ensures accurate and complete "clean" claimsubmission for both paper and electronic claims in a timely manner.

  • Keeps productivity in line with established standards bymaintaining accurate and complete productivity reports.

  • Maintains current knowledge in regards to methods ofbilling, laws or hospital rules relating to insurance claims and electronicsubmission claims.

  • Performs other required revenue cycle duties in a timely,professional, and accurate manner.

KNOWLEDGE, SKILLS AND ABILITIES:

  • Knowledgeable with Med Host, EPIC, SSI, and other billingplatforms

  • Knowledgeable about medical revenue cycle processes, fromscheduling through agency placement and final account disposition.

  • Ability to maintain confidentiality and sensitiveinformation

  • Must possess excellent time management and organizationalskills

  • Demonstrated critical thinking, creativity, problem solvingand decision-making skills

Qualifications

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

  • High school graduate

  • 2 years healthcarerevenue cycle experience

  • Hospital registration experience a plus

  • An in-depth understanding of insurance billing requirements

  • Strong proficiency in Microsoft Office tools (Excel, Word,Access and PowerPoint).

TRAVEL REQUIREMENTS:

Minimal travel

Job: Corporate Positions

Organization: QHC

Location: TN-Brentwood

Requisition ID: 1822698