Hospital Billing Executive

Job Summary:
The Hospital Billing Executive is responsible for managing and overseeing all aspects of billing for hospital services. This includes verifying patient information, preparing and submitting insurance claims, processing payments, resolving discrepancies, and ensuring compliance with health insurance regulations. The role requires close collaboration with healthcare providers, patients, and insurance companies to ensure timely and accurate billing processes.

Key Responsibilities:

• Patient Data Verification:
• Verify and validate patient details, including insurance information, medical records, and treatment codes.
• Ensure accurate demographic information is entered into the system for proper billing.
• Billing and Coding:
• Process patient bills by accurately assigning appropriate codes for diagnoses and treatments based on ICD-10, CPT, and HCPCS standards.
• Generate itemized billing statements and submit claims to insurance companies or other third-party payers.
• Insurance Verification:
• Contact insurance companies to verify coverage, benefits, and authorization for treatments.
• Ensure that all necessary approvals and pre-authorizations are obtained before proceeding with treatments and services.
• Claim Submission and Follow-Up:
• Submit claims to insurance providers and ensure timely processing.
• Monitor the status of claims and follow up with insurance companies on denied or unpaid claims.
• Investigate and resolve issues related to unpaid or rejected claims.
• Payment Posting and Reconciliation:
• Post payments from patients, insurance companies, and other third-party payers to the appropriate accounts.
• Reconcile payments with billing records and investigate discrepancies.
• Customer Service and Patient Communication:
• Communicate with patients regarding their billing inquiries, payment options, and account balances.
• Assist patients in understanding their insurance coverage, co-pays, and out-of-pocket expenses.
• Compliance and Documentation:
• Ensure billing practices comply with healthcare regulations, insurance policies, and hospital procedures.
• Maintain accurate and organized records of all billing activities, claims, and patient interactions.
• Reports and Analysis:
• Prepare regular billing reports, summarizing revenue, outstanding claims, and accounts receivable.
• Provide data and analysis to management regarding billing performance and trends.
• Collaboration with Clinical and Administrative Teams:
• Work closely with healthcare providers, medical coders, and the administrative team to resolve any issues related to patient billing and insurance claims.
• Stay updated on changes in insurance policies, billing procedures, and healthcare regulations.

Qualifications:

• Education:
• Bachelor’s degree in Finance, Healthcare Administration, or a related field is preferred
• Experience:
• At least 2-3 years of experience in hospital billing or healthcare finance.

Job Type: Full-time

Work Location: In person