Electronic Data Interchange Specialist jobs in Denver, CO

Medical Biller I

This position is responsible for validating and entering patient and insurance information into proprietary billing software. The ideal candidate will be well-versed in billing guidelines, insurance guidelines, and responding to patient and insurance inquiries. The medical biller will also be responsible for maintaining patient confidentiality and accurately inputting patient data.

Responsibilities Include:

• Ensure patient demographic information is accurate and complete
• Utilize customer hospital systems or approved vendors to research and obtain/verify patient demographic information
• Validate signature documents such as AOB (Assignment of Benefits), consents, CMN (Certificate of Medical Necessity)
• Verify patient name is consistent on all documents Verify date of service, loaded miles, locations in software align with dispatch/clinical documentation
• Verify insurance eligibility and follow coordination of benefits guidelines
• Research new payor information and follow new payor request process
• Request missing patient information from facility or by contacting patient or legal representative
• Request retro-authorization and follow up with payors Upload documents into software applicable to patient chart
• Follow federal and state billing guidelines Input demographic information to billing software and/or payor portal Initiate paper and electronic claims to payors
• Document all actions taken in both clinical and billing software Resolve electronic claim rejections
• Follow fair debt collection practices when contacting patients on past due accounts
• Review self-pay accounts to determine if all collection efforts have been exhausted
• Resolve payor specific validations in billing software prior to claim submission
• Process return mail by researching and validating new demographic information and restarting patient statement cycle
• Other responsibilities as assigned

Requirements:

• Prefer one year in medical billing field but not required
• Ability to speak confidently to insurance representatives and patients
• Experience in billing 1500 and UB04 claim forms Understanding of non-contracted and contracted payer behaviors
• Ability to adapt in a fast-paced work environment and ability to change tasks based on priority or direction from management
• Knowledge of medical terms
• Ability to work independently
• Ability to analyze and make informed decisions Maintains professional personal appearance
• Ability to interact professionally on all levels
• Able to analyze problems and provide feedback to management on strategy for efficient solutions Initiative required to learn company organization and procedures
• Adhere to company HIPAA confidentially and privacy compliance policies, business and professional ethics, Employee Handbook, and company/department policies and procedures
• Experience using Microsoft Office PDF (formatting and editing in Adobe Acrobat or equivalent)
• Position requires HS or GED equivalent Type 45 wpm, 10-key by touch
• Ability to operate office equipment

Golden Hour appreciates and values diversity. We are an equal opportunity employer and do not discriminate in hiring or employment on the basis of race, color, religion, national origin, citizenship, gender, gender identity, genetic information, marital status, sexual orientation, age, disability, veteran status, or any other characteristic protected by federal, state, or local law.

Please note this job description is not designed to cover or contain a comprehensive listing ofactivities, duties, or responsibilities that are required of the employee for this job. Duties,responsibilities, and activities will be reviewed periodically as duties and responsibilities changewith business necessity. Essential and marginal job functions are subject to modification.