High School diploma or GED is required.
Associate Degree in a related field preferred.
Minimum of two or more years work experience with one or more of the following: third party claims billing, insurance follow up, denials management, underpayments, managed care contracts, cash application, credit resolution, audit, claims processing and revenue cycle compliance in a hospital, physician's, medical service organizations or health system revenue cycle department is preferred.
Must have working knowledge and experience interpreting third party payer rules to include coordination of benefits, interpreting policy benefits, interpret contracts, state and federal regulations, overturning denials and underpayments and payment methodologies (DRG, case rates, revenue codes, fee for service) and remain current on all industry changes in billing requirements..
Working knowledge of medical terminology, ICD9 & ICD10, HCPCS, CPT codes and revenue codes for billing is required.
Organizational and time management skills and ability to work independently.
Proficiency in computer keyboarding skills required.
Ability to effectively gather and exchange information in both oral and written communications.
Detail oriented, analytical skills, root cause analysis, ability to problem solve and recommend resolutions.
Ability to use MS Office Suite (Word, Excel, Outlook) at an intermediate level.
Ability to work independently with minimal supervision.
Stays current on industry regulations and requirements