Enrollment & Billing Representative jobs in Jackson, MS

Enrollment & Billing Representative is responsible for the accurate enrollment and billing process for an insurance organization. Maintains related documents, updates corresponding records and responsible for enrollment and billing query. Being an Enrollment & Billing Representative requires a high school diploma or its equivalent. Typically reports to a supervisor or manager. The Enrollment & Billing Representative possesses a moderate understanding of general aspects of the job. Works under the close direction of senior personnel in the functional area. May require 0-1 year of general work experience. (Copyright 2024 Salary.com)

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Case Management Representative - OLOL Discharge Billing
  • St Dominic-Jackson Memorial Hospital
  • Jackson, MS OTHER
  • The Case Management Representative (CMR) coordinates the day-to-day operations of Utilization Management by providing all insurance companies with the information required to obtain approved days. Directing all denials and appeals to the appropriate person or team. The CMR will submit reviews in a timely manner for payers. Review, index, and/or respond appropriately to payer communication via OnBase. The CMR provides all communication with the insurance company to obtain approved days for the patient’s encounter. Serves as the liaison between various departments in the hospital, including HIM, Business Office, physicians' offices, and Access Services. Coordinates Medical Management Tracker, denial log, and TQ reports. This position is responsible for communicating the essential information to obtain approved for bed days from the insurance company. This communication is the driver for the payment received from the insurance company.

    Daily Operations

    • Receives calls from payors and records data in a complete and accurate format. Makes written and verbal inquiries to obtain data in a prompt and efficient manner.

    • Transcribes data from insurance companies sent via into the electronic medical record.

    • Enters data in the electronic medical record to ensure correct billing.

    • Provides notification to the Utilization Review team for any denials.

    • Sends clinical updates to insurance companies to obtain approval for hospital days.

    • Communicates with the Utilization Review Nurse any denials received from the insurance company by fax or verbally.

    • Coordinates the daily operations of Utilization Review, obtains the clinical information and forwards to payors to complete for certification. Completes all incomplete certification for all patients.

    • Communicates with providers to verify actual dates of services and other information needed to ensure efficient departmental operations.

    • Closes the encounter with completion of the bed days table and the record is then sent for billing.

    • Coordinates and prepares letters sent to internal and external customers in a prompt and efficient manner.

    Quality

    • Ensures data entered into the electronic medical record is accurate, maintains reliable data records.
    • Maintains source documents and informs appropriate personnel of changes in a timely manner.
    • Uses InterQual criteria to assist the Clinical Resource Coordinators in retrieving clinical information and abstracting for weekend Retro Reviews for providers.
    • Faxes or updates via payor portal, all completed forms and clinical documentation to providers. Maintains and organizes faxes in an effort to ensure the quality and efficiency of health care service delivery.
    • 3. Ensures accuracy of bed days and next review date prior to closing the case.

    Other Duties as assigned

    • Performs other duties as assigned or requested.

  • Just Posted

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Family Enrollment Counselor
  • Pearson
  • Jackson, MS FULL_TIME
  • About the role Working from your home office, the Family Enrolment Counselor focuses on building and maintaining positive and productive relationships with families interested in enrolling in a Connec...
  • Just Posted

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Enrollment Processing Support Specialist
  • Jones College
  • Ellisville, MS FULL_TIME
  • Position: Processing Support Specialist Department: Enrollment Management The Processing Support Specialist for Enrollment Management is to provide support for the department and students with meeting...
  • 15 Days Ago

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Coordinator, Dual Enrollment
  • Alcorn State University
  • Lorman, MS FULL_TIME
  • Please see Special Instructions for more details. EEO Statement: Alcorn State University does not discriminate on the basis of race, color, religion, national origin, sex, sexual orientation, age, dis...
  • 1 Month Ago

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Billing Specialist
  • Simpson General Hospital
  • Mendenhall, MS FULL_TIME
  • At Simpson General Hospital (SGH), we pride ourselves in providing high quality healthcare in a hometown environment! Job title: Medical Billing Specialist Work Location: Business Office (Financial Se...
  • 19 Days Ago

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Billing coordinator
  • Equiniti
  • Jackson, MS FULL_TIME
  • Management Level Equiniti is a leading international provider of shareholder, pension, remediation, and credit technology. With over 6000 employees, it supports 37 million people in 120 countries. EQ ...
  • 23 Days Ago

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0 Enrollment & Billing Representative jobs found in Jackson, MS area

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Accounting Lead - Remote & Haiti
  • Amentum
  • Jackson, MS
  • Amentum, a large government contract company, is seeking an Accounting Lead to support a pending contract award in Haiti...
  • 3/28/2024 12:00:00 AM

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Chief - Payer Relations & Managed Care
  • University of Mississippi Medical Center
  • Jackson, MS
  • Hello, Thank you for your interest in career opportunities with the University of Mississippi Medical Center. Please rev...
  • 3/28/2024 12:00:00 AM

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Commercial Lines Client Representative
  • Ross & Yerger Insurance, Inc.
  • Jackson, MS
  • Major Duties and Responsibilities: Process endorsements, audit, policies, cancellations, reporting forms and invoicing a...
  • 3/28/2024 12:00:00 AM

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Service Writer
  • United Rentals, Inc.
  • Richland, MS
  • Great company. Great people. Great opportunities. If you'd like the chance to make your mark with the world's largest eq...
  • 3/28/2024 12:00:00 AM

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Legal Billing Clerk
  • Strategic Recruitment Solutions
  • Jackson, MS
  • Job Description Job Description We are seeking a dynamic individual to join our client’s law firm in Downtown Jackson as...
  • 3/26/2024 12:00:00 AM

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Outside Sales Representative
  • Thryv
  • Jackson, MS
  • A Bit About Us: This is a very exciting time for Thryv as we are making waves in becoming an international leading SaaS ...
  • 3/25/2024 12:00:00 AM

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Application Developer
  • LanceSoft Inc
  • Jackson, MS
  • Title: Application Developer Duration: with possibility of extension Location: Jackson, MS Note: Onsite Position Job Des...
  • 3/25/2024 12:00:00 AM

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EN-ROUTE REPAIR SPECIALIST (NIGHT SHIFT)
  • KLLM Transport Services, LLC.
  • Richland, MS
  • Job Description Job Description SHIFT: 7pm - 7am / 4 On 4 Off Job Duties and Responsibilities: This position will perfor...
  • 3/24/2024 12:00:00 AM

Jackson is located primarily in northeastern Hinds County, with small portions in Madison and Rankin counties. The Pearl River forms most of the eastern border of the city. A small portion of the city containing Tougaloo College lies in Madison County, bounded on the west by Interstate 220 and on the east by U.S. Route 51 and Interstate 55. An unconnected section of the city surrounds Jackson–Evers International Airport in Rankin County. In the 2010 census, only 622 of the city's residents lived in Madison County, and only 1 lived within the city limits in Rankin County. The city is bordered t...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Enrollment & Billing Representative jobs
$30,459 to $38,712
Jackson, Mississippi area prices
were up 1.2% from a year ago

Enrollment & Billing Representative in Boca Raton, FL
Showing up in person often demonstrates determination and initiative that most employers will find alluring in a potential representative.
February 13, 2020