The Billing Representative performs insurance/billing review and verification of patient account information against insurance program specifications. Communicates and interacts with colleagues, hospital staff, patients, public, physicians and their staff and third party insurance personnel. Is responsible for reporting identified safety issues such as hazardous environments (i.e. damaged floors/walls/ceiling tiles/unsecured areas) and medical errors.
- Analyze and verify coding of procedures and diagnosis using ICD and CPT codes.
- Charge entry for all hospital (inpatient and outpatient), office, nursing homes, and all other provider services.
- Consults with Compliance Department on billing issues.
- Enter data electronically to process charges, payments, denials, and adjustments.
- Instructs new employees on billing and IDX input. Educates employees in billing system and billing protocols.
- Keeps updated on all third party billing requirements and changes for insurance types within their area of responsibility.
- Makes accounts private and notifies patients when claims have not been paid after periods in established accounts receivable policy.
- Monitors claims for missing information, authorization/control numbers.
- Post third party insurance remittance vouchers if received in practice site.
- Resolve routine patient billing inquiries and problems.
- Reviews billing in all sites for accuracy.
- Secures needed medical documentation required or requested by third party insurances.
- Processes rejections to correct any billing errors and resubmitting claims to third party insurance carriers.
- Works with physician or medical record staff to ensure that correct diagnosis/procedures are reported to third party insurance carriers
- High School Diploma or GED required within one (1) year of hire. Candidates who do not possess a High School Diploma or GED equivalent at time of hire will be provided the opportunity to enroll in a GED/HSEA program as a condition of employment. New hires will be provided one (1) year from date of hire to successfully complete a GED program and obtain their HSEA.*
- Completed coursework in insurance billing, data processing and medical terminology preferred.
- Knowledge of ICD & CPT coding.
- CPC (Certified Professional Coder) certification or CPB (Certified Professional Biller) preferred
- Experience with surgical billing highly preferred
*RWJBarnabas Health is committed to our communities and the members we serve. RWJBH understands that in order to create strong, healthy, and sustainable communities, we have to re-engineer and transform current systems. Providing educational support and resources contributes to our overall social impact mission and community investment efforts.
Monday - Friday, 8:30am - 5:00pm
Hours may vary based on business needs*
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Equal Opportunity Employer
RWJBarnabas Health is the most comprehensive health care delivery system in New Jersey, with a service area covering five million people. The system includes eleven acute care hospitals Clara Maass Medical Center in Belleville, Community Medical Center in Toms River, Jersey City Medical Center in Jersey City, Monmouth Medical Center in Long Branch, Monmouth Medical Center Southern Campus in Lakewood, Newark Beth Israel Medical Center in Newark, RWJUH- New Brunswick, RWJUH- Somerset in Somerville, RWJUH- Hamilton, RWJUH- Rahway and Saint Barnabas Medical Center in Livingston; three acute care children s hospitals and a leading pediatric rehabilitation hospital (Children s Specialized Hospital), a freestanding 100-bed behavioral health center, trauma centers, a satellite emergency department, ambulatory care centers, geriatric centers, the state s largest behavioral health network, comprehensive home care and hospice programs, fitness and wellness centers, retail pharmacy services, a medical group, multi-site imaging centers and an accountable care organization.
RWJBarnabas Health Medical Group is a multispecialty group practice comprised of highly trained and experienced world class primary and specialty care physicians. RWJBarnabas Health Medical Group physicians provide compassionate and innovative cutting-edge care for people at every stage of life at easily accessible facilities conveniently located throughout New Jersey. Backed by the vast continuum of resources of RWJBarnabas Health, the largest not-for-profit integrated health care delivery system in New Jersey and one of the largest in the nation, our dedicated physicians and expertly trained supporting staff continuously strive for clinical excellence.
We offer a great work environment, competitive rates and excellent benefits, including:
- Medical/Dental/Vision plans
- 401 (k)
- Short & Long Term Disability
- Basic Life & Accidental Death Insurance
- Tuition Reimbursement
- Health Care/Dependent Care Flexible Spending Accounts
Equal Opportunity Employer
RWJBarnabas Health is an Equal Opportunity Employer
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