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Billing & Posting Resolution Provider

American HealthTech

American HealthTech

United States · Remote
Posted on Feb 4, 2025

Job Summary:

The Billing & Posting Resolution Provider position is responsible for acting as a liaison for hospitals and clinics using TruBridge’s complete business office services. They work closely with TruBridge management and hospital employees to bill insurance companies for all hospital, hospital-based physician and clinic bills. They pursue collection of all claims until payment is made by insurance companies; and perform other work associated with the billing process.

Essential Functions:

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

  • Prepares and submits hospital, hospital-based physician and clinic claims to third-party insurance carriers either electronically or by hard copy billing.
  • Secures needed medical documentation required or requested by third party insurances.
  • Follows up with third-party insurance carriers on unpaid claims till claims are paid or only self-pay balance remains.
  • 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.
  • Ensure all claims are submitted daily with a goal of zero errors.
  • Timely follow up on insurance claim status.
  • Reading and interpreting an EOB (Explanation of Benefits).
  • Respond to inquiries by insurance companies.
  • Denial Management.
  • Meet with Billing Manager/Supervisor to discuss and resolve reimbursement issues or billing obstacles.
  • Review late charge reports and file corrected claims or write off charges as per client policy.
  • Review reports identifying readmissions or overlapping service dates and ignore, merge, or split-bill according to the payer’s rules and the client’s policy.
  • Review credit reports, resolve credits belonging to a payer when able, and submit a listing of credits to the facility as required by the payer.

Minimum Requirements:

Education/Experience/Certification Requirements

  • 3 years of recent Critical Access or Acute Care facility billing or 3 years of physician billing experience.
  • Medicare Billing Experience Required.
  • 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.