Job Description

Description

Salary Range: $33.78 - $41.46 + applicable differentials 

Essential Job Responsibilities

Achieving Results;

• Under the guidance of the Revenue Cycle Director, the Government and Commercial Billing Managers are tasked with billing various account types, encompassing HMOs, PPOs, Worker’s’ Compensation, Government Payers and Self-pay accounts.
• Ensure all necessary documentation is present for billing patient accounts.
• Coordinates with various insurance carriers to meet standard requirements, ensuring appropriate payment of claims and adherence to guidelines before billing.
• Processes claims using the designated electronic billing system corresponding to the insurance plan, with any remaining claims billed in hardcopy to the relevant insurance carrier.
• Collaborates with relevant personnel and hospital departments to ensure accurate diagnosis and procedure coding on claims.
• Reviews past due accounts and associated documents to identify and access delinquency issues.
• Conducts reviews of claims denials, identifies root causes, and takes necessary actions, including follow-ups and appeals in a timely manner.

Demonstrates Skills;

• Investigates reasons for claim denials to uncover any unique circumstances contributing to payment delays and communicates with relevant parties for follow-up, potentially seeking assistance from Payer Contracting, Case Management, and Health Information Management (HIM)/Coding departments.
• Executes a comprehensive array of tasks, potentially rotating assignments or specializing in a particular area as needed.
• Demonstrates proficiency in all computer systems essential for completing job responsibilities and comprehends the integration of information across all financial systems.

Planning and Coordinating;

• Responsible for daily claims processing and billing
• Completes assigned work queues and handles daily incoming correspondence.
• Participates in mandatory annual events and education sessions.

Washington Hospital Health System does not utilize any form of electronic chatting, such as Google chat for the purposes of interviewing candidates for employment. If you are contacted by any entity or individual attempting to engage you in this format, do not disclose any personal information and contact Washington Hospital Healthcare System.

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