Job Details

The Hospital Claims Biller - Follow-up (UB04) position is responsible for acting as a liaison for hospitals and clinics using TruBridge Accounts Receivable Management Services. They work closely with TruBridge management and hospital employees in receiving, preparing and posting of receipts for hospital services while ensuring the accuracy in the posting of the receipt, contractual allowance and other remittance amounts. Candidates must be detail oriented with excellent verbal and written communication skills, organizational skills, and time management skills.

These Goals and objectives are not to be construed as a complete statement of all duties performed; employees will be required to perform other job related duties as required. Goals and objectives are subject to change.

All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.

Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:

• Receives daily receipts that have been balanced and stamped for deposit and verifies receipt total.
• Research receipts that are not clearly marked for posting.
• Post payments to the appropriate account and makes notes required for follow-up.
• Posts zero payments to the appropriate account and makes notes required for follow-up.
• Maintains log of daily receipts and contractual posted.
• Processes rejections by either making accounts private or correcting any billing error and resubmitting claims to third-party insurance carriers.
• Responsible for consistently meeting production and quality assurance standards.
• Maintains quality customer service by following company policies and procedures as well as policies and procedures specific to each customer.
• Updates job knowledge by participating in company offered education opportunities.
• Protects customer information by keeping all information confidential.
• Processes miscellaneous paperwork.
• Ability to work with high profile customers with difficult processes.
• May regularly be asked to help with team projects.
• 3 years hospital payment posting, including time outside Trubridge.
• Display a detailed understanding of CAS codes.
• Post denials to patient accounts with the correct denial reason code.
• Post patient payments, electronic insurance payments, and manual insurance payments.
• Balance all payments and contractual daily.
• Make sure postings balance to the site's bank deposit.
• Adhere to site specific productivity requirements outlined by management.
• Serve as a resource for other receipting service specialists.
• Must be agile and able to easily shift between tasks.
• May require overtime as needed to ensure the day/month are fully balanced and closed.
• Assist with backlog receipting projects, such as unresolved situations in Thrive, researching credit accounts, and reconciling unapplied.

Minimum Requirements:

Education/Experience/Certification Requirements

• 1-3 years hospital claims processing experience, specifically processing UB-04 claims (inpatient)
• Computer skills.
• Experience in CPT and ICD-10 coding.
• Familiarity with medical terminology.
• Ability to communicate with various insurance payers.
• Experience in filing claim appeals with insurance companies to ensure maximum reimbursement.
• Responsible use of confidential information.
• Strong written and verbal skills.
• Ability to multi-task.

Business Support