About this role
The Meditech Claims Processor position is responsible for acting as a liaison for hospitals and clinics using TruBridge’s complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all hospital, hospital-based physician and clinic bills. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
• Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing. • Secures needed medical documentation required or requested by third party insurances. • Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains. • Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers. • Responsible for consistently meeting production and quality assurance standards. • Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer. • Updates job knowledge by participating in company offered education opportunities. • Protects customer information by keeping all information confidential. • Processes miscellaneous paperwork. • Ability to work with high profile customers with difficult processes. • May regularly be asked to help with team projects. • Ensure all claims are submitted daily with a goal of zero errors. • Timely follow up on insurance claim status. • Reading and interpreting an EOB (Explanation of Benefits). • Respond to inquiries by insurance companies. • Denial Management. • Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles. • Review late charge reports and file corrected claims or write off charges as per client policy. • Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy. • Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.
Minimum Requirements: Education/Experience/Certification Requirements
• 3 years of recent Critical Access or Acute Care facility and professional claim billing • Meditech E.H.R Experience Required. • Computer skills. • Experience in CPT and ICD-10 coding. • Familiarity with medical terminology. • Ability to communicate with various insurance payers. • Experience in filing claim appeals with insurance companies to ensure maximum reimbursement. • Responsible use of confidential information. • Strong written and verbal skills. • Ability to multi-task.