Hospital Billing Associate

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A Brief Overview

The Hospital Billing Team are seeking a motivated and detail-oriented Hospital Billing Associate to join our team. In this role, you will be responsible for timely and accurate claim submissions to healthcare insurance carriers for hospital, services, following established procedures and using current billing technologies. You will play a key role in supporting CHOP's mission through efficient and effective revenue cycle management.

This is a production-based position, requiring the Billing Associate to work through 100 accounts per day while maintaining a quality standard of 90% or higher through regular audits. Responsibilities include correcting edits and working error queues, so strong attention to detail and the ability to work independently are essential.

We are looking for someone who is not only a strong individual contributor, but also a collaborative team player with a personable attitude and a desire to learn and grow within the organization. Experience with Epic is a plus.

This role focuses on commercial and Medicaid managed care payers and is not limited to a specialized billing area.

Work Location: This is a hybrid position. The associate is required to work on-site one day per week, every Tuesday.

What you will do

• Submits timely, accurate claims to insurance carriers according to insurance payor guidelines through established methods and procedures using current available technology.

• Promptly and accurately resolves claim edits.

• Collaborates with CHOP departments to resolve outstanding claims not meeting payer claim edits for reimbursement processing.

• Ensures all claims are accepted by payers for payment processing.

• Utilizes electronic/clearinghouse billing software to process claims.

• Utilizes various tools including websites, payor documents, and internal denial analytics reports to perform duties.

• Ability to research, resolve and accurately document.

• Identifies third-party payor response trending and escalates to the management team as deemed necessary.

• Meets established daily/weekly reasonable work expectations of productivity and quality requirements.

• Other duties as assigned within scope of responsibilities.

• Understanding of the revenue cycle process and third-party health plan and government payer requirements for compliant, accurate claims processing.

• Ability to work the internet for access to insurance payer portals.

• Ability to manage daily job functions along with special project work and prioritize level of importance on demand.

• Experience with Epic (preferred).

• Ability to communicate effectively and collaborate with teams across Patient Financial Services and other departments around operational efficiencies.

• Interfaces well with all levels of staff and management.

• Suggests ideas and solutions for performance and quality improvement and provides feedback to team leaders.

• Provides training as assigned to new employees, as well as cross-training.

• Maintains all PHI in accordance with HIPAA, JACHO, third-party contractual agreements, and CHOP policy and procedures.

• Demonstrates behaviors that are consistent with CHOP's organizational values of Integrity, Compassion, Accountability, Respect, and Excellence (ICARE). Ensures work is performed, relationships are built, responsibility is assumed, and service delivered expresses CHOP's values through action.

• Reports safety hazards, accidents and incidents, and unsafe working conditions promptly.

• Consistently supports compliance by maintaining the privacy and confidentiality of information, protecting the assets of the organization, acting with ethics and integrity, reporting non-compliance, and adhering to applicable federal, state, and local laws and regulations.

Education Qualifications

• High School Diploma / GED - Required
• Associate's Degree - Preferred

Experience Qualifications

• At least one (1) year experience in billing, payment posting, operations, or related role - Required
• At least two (2) years experience in billing, payment posting, operations, or related role - Preferred
• Experience with Epic systems Preferred

Skills and Abilities

• Knowledge of HIPAA compliance standards

• Effective communication, interpersonal skills, analytical skills, and problem-solving skills

• Excellent organizational and time management skills

• Detail- and results-oriented

• High aptitude for math

• Excellent writing and oral communication skills

• Ability to work independently and prioritize work

• Basic computer skills

• High proficiency in Microsoft Excel

• Demonstrated customer service skills, customer focus abilities, and the ability to understand Children's Hospital of Philadelphia customer needs

• Must maintain high-level knowledge of claim submission requirements

• Ability to work cooperatively in a team environment

• Demonstrated effective interpersonal, verbal, and written communication skills

• Knowledge of Microsoft Office applications including Word and Excel

• Must have 10-key by touch

• Demonstrated experience with multiple computer applications

• Knowledge of third-party reimbursement and physician/hospital billing

• Experience in using commonly used electronic health records and healthcare revenue cycle financial management systems

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must receive an annual influenza vaccine. Learn more.

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SALARY RANGE:

Salary ranges are shown for full-time jobs. If you're working part-time, your pay will be adjusted accordingly.

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At CHOP, we are committed to fair and transparent pay practices. Factors such as skills and experience could result in an offer above the salary range noted in this job posting. Click here for more information regarding CHOP's Compensation and Benefits.