Senior Billing Representative

The Senior Billing Representative is responsible for timely and accurate submission of hospitals’ primary, secondary, and tertiary patient bills to Medicare, Medicaid, Blue Cross, commercial and other government/non-government insurance payors.

 Serves as a back-up to the Billing Team Lead, communicates payor issues, delays, and concerns to Leadership on a consistent basis and to customers as needed.

Primary Job Duties


* Coordinate’s hospital daily billing within controls to ensure all billing is completed and abides by billing techniques and standards as established by hospital/MEDHOST Business Services.


* Assist Team Lead with planning daily workflow and work distribution to ensure the billing inventory for assigned customers is managed and the company’s billing goals are met.


* Communicates directly with Team Lead/Manager of issues impairing the billing process, impacting claim resolution, and required tools for effective billing.


* Assist Team Lead with reviewing and approving adjustments weekly.


* Builds and maintains strong, long-lasting customer relationships.


* Working partnership with other teams/departments regarding resolution of billing/payor payment issues and concerns.


* Assists billing representatives and follow-up representatives with questions related to billing activities.


* Assist team in working claims generated on the late charge reports, rejected claims, claims in error, DDE claims and ghost claims daily.


* Ensure facility Rebills are worked and comments logged on patient accounts within 7 business days.


* Monitor and ensure staff work within Medicare DDE system to resolve RTP claims daily for their assigned customers.


* Active participation on customers’ weekly, bi-weekly and/or monthly meetings to review billed account inventory as needed, with focus on performance reporting and issue resolution.


* Verbal and written communication with customers to retrieve information for rebills/corrected claims and communicate with insurance payors to work claims not processed/paid.

Working outstanding claims will require a broad range of strategies including phone calls, letters, faxing, emails, rebilling, and filing corrected claims.


* Assist with high severity requests and billing issue escalations.


* Performs billing activities and coordinates billing workload coverage when there are unplanned staffing outages.


* Timely and appropriate processing of billing/rebilling requests from customers and team members within the department.


* Continued education of billing practices for private and government payors.


* Maintains working knowledge of software applications related to billing claims to payors.


* Assist in the training and education of new and existing employees.


* Performs other duties as assigned.

Additional Job Description


* Assist with creating and maintaining department and customer documentation


* Provide tr...