Capital Health is the region's leader in providing progressive, quality patient care with significant investments in our exceptional physicians, nurses and staff, as well as advanced technology. Capital Health is a five-time Magnet-Recognized health system for nursing excellence and is comprised of 2 hospitals. Capital Health Medical Group is made up of more than 250 physicians and other providers who offer primary and specialty care, as well as hospital-based services, to patients throughout the region.
Capital Health recognizes that attracting the best talent is key to our strategy and success as an organization. As a result, we aim for flexibility in structuring competitive compensation offers to ensure we can attract the best candidates.
The listed pay range or pay rate reflects compensation for a full-time equivalent (1.0 FTE) position. Actual compensation may differ depending on assigned hours and position status (e.g., part-time).
Pay Range:
$18.21 - $26.46
Scheduled Weekly Hours:
40
Position Overview
Implant/Trailer Billing Rep
JOB CODE:50360
SUMMARY (BASIC PURPOSE OF THE JOB)
Prepares and submits claims and responds to routine inquiries regarding claims. Contacts payors regarding status of outstanding claims. Documents all correspondence, payments and adjustments into the patient account record via patient accounts system.
MINIMUM REQUIREMENTS
Education: High school diploma or equivalency.
Experience: One year billing experience in a healthcare environment.
Other Credentials:
Knowledge and Skills: Ability to navigate through multiple systems. Excellent communication and interpersonal skills. Requires typing skills and data entry skills with emphasis on accuracy. Knowledge and ability to interpret payor contracts preferred.
Special Training: Working knowledge of Microsoft office.
Mental, Behavioral and Emotional Abilities:
Usual Work Day:8 Hours
ESSENTIAL FUNCTIONS
- Reviews appropriate documents. Interprets information and follows appropriate federal, state, third party and departmental guidelines to prepare bills to carriers. Complies with implant and trailer billing procedures, as required by the hospital's managed care contracts.
- Identifies and bills all implant or trailer services as outlined by work lists, management and hospital managed care contracts through access to multiple systems.
- Gathers and communicates information from third party payors to expedite payment on outstanding accounts.
- Stays current with the latest updates for third party, collection, and bad-debt regulations by reading bulletins and other memoranda. Participates in annual training sessions as required.
- Sets goals to resolve any outstanding issues with third party representatives.
- Evaluates, reviews, and analyzes patient accounts to determine if correct third party payments have been received and recorded. Ensures compliance with contract terms. Follow up with the payors regarding non-payment or any discrepancy in payments received.
- Prioritizes and updates files and other required documentation in accordance with established policies, guidelines, and procedures.
- Reviews and stays current with assigned work lists daily.
- Operates computer software efficiently to complete required billing and follow-up tasks.
- Performs other duties as assigned and adapts to changing departmental demands.
PHYSICAL DEMANDS AND WORK ENVIRONMENT
Frequent physical demands include: Standing , Walking
Occasional physical demands include: Climbing (e.g., stairs or ladders) , Carry objects , Push/Pull , Twisting , Bending , Reaching forward , Reaching overhead , Squat/kneel/crawl , Wrist position deviation , Pinching/fine motor activities , Keyboard use/repetitive motion
Continuous physical demands include: Sitting
Lifting Floor to Waist 20 lbs. Lifting Waist Level and Above 10 lbs.
Sensory Requirements include: Accurate Near Vision, Accurate Far Vision, Color Discrimination, Minimal Depth Perception, Minimal Hearing
Anticipated Occupational Exposure Risks Include the following: N/A
This position is eligible for the following benefits:
- Healthcare FSA
- Dependent Care FSA
Retirement Savings and Investment Plan
Basic Group Term Life and Accidental Death & Dismemberment (AD&D) Insurance
Supplemental Group Term Life & Accidental Death & Dismemberment Insurance
Disability Benefits – Long Term Disability (LTD)
Disability Benefits – Short Term Disability (STD)
Employee Assistance Program
Commuter Transit
Commuter Parking
Supplemental Life Insurance
- Voluntary Life Spouse
- Voluntary Life Employee
- Voluntary Life Child
Voluntary Legal Services
Voluntary Accident, Critical Illness and Hospital Indemnity Insurance
Voluntary Identity Theft Insurance
Voluntary Pet Insurance
Paid Time-Off Program
The pay range listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining base salary and/or rate, several factors may be considered including, but not limited to location, years of relevant experience, education, credentials, negotiated contracts, budget, market data, and internal equity. Bonus and/or incentive eligibility are determined by role and level.
The salary applies specifically to the position being advertised and does not include potential bonuses, incentive compensation, differential pay or other forms of compensation, compensation allowance, or benefits health or welfare. Actual total compensation may vary based on factors such as experience, skills, qualifications, and other relevant criteria.
