Role & Administrative Scope:
Primary Scope: Manage revenue cycle workflows including cash posting, claims follow-up, underpayment resolution, and denial management for hospital billing.
Core Responsibilities:
- Post cash payments and reconcile accounts.
- Execute claims follow-up and resolve claim denials, underpayments, and Coordination of Benefits (COB) issues.
- Verify patient insurance eligibility directly with commercial payors.
- Communicate directly with insurance carriers and patients regarding co-pays, deductibles, and outstanding balances.
- Resolve outstanding patient accounts in a timely, accurate, and effective manner while delivering excellent customer service.
Primary Payor Networks: Commercial payors including Aetna, UnitedHealthcare, Horizon, and Independence Blue Cross (IBX).
Schedule & Hours:
- Shift Type: Days.
- Shift Times: 07:00 AM – 3:30 PM.
- Shift Duration: 8 Hours / Day (Plus unpaid meal break).
- Weekly Commitment: 40 Hours / Week.
Candidate Requirements & Qualifications:
Education: High School Diploma or Equivalent [REQUIRED].
Professional Experience:
- 2 to 3 years of dedicated hospital billing experience [REQUIRED].
- Proven experience handling claims follow-up, denials, and cash posting [REQUIRED].
- Strong familiarity working with major commercial insurance payors [REQUIRED].