Hospital Billing Representative I
Company: Baptist Health Care
Location: Pensacola
Posted on: May 3, 2025
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Job Description:
Job Description
The Hospital Billing Representative I is responsible for various
tasks in the Accounts Receivables reconciliation process including
but not limited to: examining, correcting and consistently updating
Patient Health Information to ensure accurate insurance
billing/payment/follow-up; submit bills electronically to payers
using designated claims software for the corporation; reviewing
rejected claims in such billing software to scrub claims and send
them clean to the payer to avoid denials; applying appropriate
contractual and self-pay adjustments; resolving patient and
insurance carrier inquiries; communicate with physician offices, as
necessary, to obtain authorizations or notify them of medically
unnecessary orders for diagnostics; using on-line systems provided
by multiple payers to verify eligibility and benefits and checking
claim status; maintain appropriate/ consistent documentation on
accounts worked; apply proper account management principals to
accounts to ensure accurate billing; identify non-payment trends by
payer and notify management; work based on goals set by management
for productivity of validated claims being submitted on a daily
basis; makes account corrections as necessary to ensure prompt
payment of claims, regardless of which department is responsible
for obtaining this information; prints and mails medical records
and itemized statements as necessary for payers requiring paper
claims submissions; if necessary, phones patients or employers to
verify health insurance or worker's compensation information in
order to submit claims timely and accurately; maintains a high
level of professionalism and communication when it comes to working
with other areas of the business office or revenue cycle in an
effort to submit bills timely and accurately
Responsibilities
Responsible for billing process for patient accounts including but
not limited to: examining, correcting and consistently updating
patient health insurance claims to ensure prompt insurance
payment/follow-up. Resolves patient and insurance carrier inquiries
related to billing for the revenue cycle. Uses on-line systems
provided by multiple payers to verify eligibility and benefits and
checking claim status appropriately. Makes telephone calls to the
payer to inquire about denial trends in billing to ensure claims
are sent "clean". Maintains appropriate/consistent documentation on
accounts worked within the patient accounting systems. Reviews
memos on accounts within patient accounting systems for all
reprinted or rebilled claims to ensure any necessary
updates/changes are made before submission to the payer. Identifies
non-payment trends by payer and notifies systems coordinators and
management in order to change billing tables to bill accurately or
to adjust off timely, to reduce number of A/R days.Assist in other
duties as assigned to support the operational needs of the
department and organization. May be required to remain on campus
immediately before, during, and after severe weather and/or
disasters.
Qualifications
Minimum Education
Minimum Work Experience
About Us
Baptist Health Care is a not-for-profit health care system
committed to improving the quality of life for people and
communities in northwest Florida and south Alabama. The
organization includes three hospitals, four medical parks, Andrews
Institute for Orthopaedic & Sports Medicine, and an extensive
primary and specialty care provider network. With more than 4,000
team members, Baptist Health Care is one of the largest
non-governmental employers in northwest Florida.
Baptist Health Care, Inc. is an Equal Opportunity Employer. BHC
maintains and enforces a policy that prohibits discrimination
against any workforce members or applicants for employment because
of sex, race, age, color, disability, marital status, national
origin, religion, genetic information, or other category protected
by federal, state or local law.
Keywords: Baptist Health Care, Pensacola , Hospital Billing Representative I, Accounting, Auditing , Pensacola, Florida
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