Commercial Biler - Steward Health Care
Houston, TX 77002
About the Job
Location: St. Joseph Medical Center
Posted Date: 9/26/2024
Job Type: Full Time
Department: 4119.71800 Communications
Job Objective:
Under the direction of the Director of Revenue Cycle or designee, the Commercial Billing Specialist ensures all Commercial / Managed Care claims are reviewed for claim edits, claim submission, and timely follow up, as assigned.
Duties and Responsibilities:
- Review claims before submission for missing modifiers, charges, and/or implants
- Validate and make corrections on the UB04 resolving all claim edits before claim submission
- Validate pharmacy quantities are reflected on the claim correctly
- Validate claim against the coding abstract to ensure accurate billing of procedures
- Review 24 and 72-hour admission report combining claims, as needed
- Split inpatient claims as appropriate, per carrier guidelines
- Submit claims to carriers with the appropriate remarks and/or attachments
- Run insurance eligibility and correct claim before submission, as needed
- Pull supporting documents for annual regulatory audits, as needed
- Ensure credit balances are reviewed and resolved timely
- Other billing assignments, within skillsets and abilities
Education
High School graduate or equivalent
Experience
- Minimum 2-years Commercial / Managed Care billing experience in an acute care facility
- Working knowledge of Common Procedural Terminology (CPT) and ICD10 Codes
- Working knowledge of Federal, State, and Commercial billing guidelines
- Healthcare experience preferred
Source : Steward Health Care