Remote Hospital Medicaid Biller

Summary

Join Ni2 Health as a Hospital Medicaid Biller and contribute to the Billing Team's success. The ideal candidate is action-oriented and eager to learn and grow within the organization.

Requirements

• Understanding of Texas Medicaid billing rules
• Knowledge of Microsoft Office Suite software
• Minimum of 5 years required with Medicaid/Medicaid HMO billing in a hospital setting (will consider Medicaid follow-up experience)
• Have proven experience with hospital inpatient/outpatient billing
• 5 years of experience with TMHP system
• Be able to function independently to bill hospital and professional claims
• Be able to function independently to complete thorough follow-up on hospital AR
• Be able to function independently to complete thorough processes for proper denial management

Responsibilities

• Research and re-bill unpaid claims
• Bill hospital and professional claims
• Use TMHP for claims processing and AR follow-up
• Responsible for verifying insurance benefits or payment source on all patients
• Responsible for set up of patient financial files
• Accurate computer data input on all patients, notes, and claims
• Generates invoices for insurance billing, individual account billing, and follow-up billing for deductibles and copays
• Research denied or pending claims and provides additional information to facilitate claim payment
• Negotiates with the responsible party on accounts more than sixty days past due
• Responsible for collection of patient information and verification of reimbursement source. Maintains patient financial files. Generates billing invoices and is responsible for collections
• Research and resolve accounts appearing in Follow-up Reports
• Make appropriate decisions and calls to carriers to maximize reimbursement on accounts to be worked
• Correct all errors on electronic error reports using all the available information
• Meet production and quality standards
• Assists in identifying current and/or potential billing issues
• Participates in daily production assignments that will continue to develop an understanding and knowledge of processing guidelines and expectations of respective client(s) payer mix
• Ability to take patient phone calls and assist Customer Service when business needs arise

Benefits

Full benefits to include 401k with company match, progressive PTO policy with paid holidays