Medical Billing Representative

Must Have's for the Role

  • 1-3 years of experience analyzingpatient accounts for revenue purposes
  • 1-3 years of experience working invarious billing systems and payer eligibility systems
  • Basic to Intermediate excel skills
  • Excellent communication skills andcomfortable on phones

Dynamics of the Role

To determine where revenue opportunity exists or to escalatecomplex accounts for tier two analysis performed by Rep I with over one yearexperience. Initial review includes analysis of hospital data in conjunctionwith supplemental data to determine if billing has been performed accuratelyand completely.

How you'll contribute:

  • Initiate Insurance Eligibility requests as needed and reviewresponses that are both system and manually initiated for NY Medicaid &Medicare
  • If billing has not occurred, an analysis must be performed todetermine the reason why and the appropriate next action required
  • Articulate findings and instructions to the client in a clear andconcise manner
  • Analyze patient accounts to determine whether payments have beenreceived and posted before being reviewed by a Rep II
  • Independently and accurately manage 60-100 accounts per day

Ability to understand and navigate variousfinancial applications

  • Ability to log in and navigating variouspatient account systems
  • Feel comfortable with viewing, sortingfinancial data
  • Executes on reviewing open account balanceson a monthly basis by hospital

Can identify and understand the followingbilling metrics

  • Diagnostic Related Groupings
  • Professional Procedural Codes
  • Diagnosis codes

Reviews Inpatient and Outpatient open anddenied claims

  • Determines patient eligibility for any Stateor Federal Programs
  • Determines patient eligibility for commercialaccounts
  • Understand patient accounting conceptsassociated with
  • Payments, billing activity and policy number
  • Ability to review patient accounting notesand take action
  • Prepares monthly client listing forsupervisor to review

Aged Finding

  • communicate with supervisor / client managersif prior month findings were not updated
  • Assists with identifying accounts not to bereviewed the follow month

Who We Are

AtTransUnion, we are dedicated to finding ways information can be used to helppeople make better and smarter decisions. As a trusted provider of globalinformation solutions, our mission is to help people around the world accessthe opportunities that lead to a higher quality of life, by helpingorganizations optimize their risk-based decisions and enabling consumers tounderstand and manage their personal information. Because when people haveaccess to more complete and multidimensional information, they can make moreinformed decisions and achieve great things.

Everyday TransUnion offers our employees the tools and resources they need to findways information can be used in diverse ways. Whether it is helping businessesbetter manage risk, providing better insights so a consumer can qualify for hisfirst mortgage or working with law enforcement to make neighborhoods safer, weare improving the quality of life for individuals, families, communities andlocal economies around the world.

Weare an equal opportunity employer and all qualified applicants will receiveconsideration for employment without regard to race, color, religion, sex,national origin, age, disability status, veteran status, marital status,citizenship status, sexual orientation, gender identity or any othercharacteristic protected by law.

#LI-EF1

Must Have's for the Role

  • 1-3 years of experience analyzingpatient accounts for revenue purposes
  • 1-3 years of experience working invarious billing systems and payer eligibility systems
  • Basic to Intermediate excel skills
  • Excellent communication skills andcomfortable on phones

Dynamics of the Role

To determine where revenue opportunity exists or to escalatecomplex accounts for tier two analysis performed by Rep I with over one yearexperience. Initial review includes analysis of hospital data in conjunctionwith supplemental data to determine if billing has been performed accuratelyand completely.

How you'll contribute:

  • Initiate Insurance Eligibility requests as needed and reviewresponses that are both system and manually initiated for NY Medicaid &Medicare
  • If billing has not occurred, an analysis must be performed todetermine the reason why and the appropriate next action required
  • Articulate findings and instructions to the client in a clear andconcise manner
  • Analyze patient accounts to determine whether payments have beenreceived and posted before being reviewed by a Rep II
  • Independently and accurately manage 60-100 accounts per day

Ability to understand and navigate variousfinancial applications

  • Ability to log in and navigating variouspatient account systems
  • Feel comfortable with viewing, sortingfinancial data
  • Executes on reviewing open account balanceson a monthly basis by hospital

Can identify and understand the followingbilling metrics

  • Diagnostic Related Groupings
  • Professional Procedural Codes
  • Diagnosis codes

Reviews Inpatient and Outpatient open anddenied claims

  • Determines patient eligibility for any Stateor Federal Programs
  • Determines patient eligibility for commercialaccounts
  • Understand patient accounting conceptsassociated with
  • Payments, billing activity and policy number
  • Ability to review patient accounting notesand take action
  • Prepares monthly client listing forsupervisor to review

Aged Finding

  • communicate with supervisor / client managersif prior month findings were not updated
  • Assists with identifying accounts not to bereviewed the follow month

Who We Are

AtTransUnion, we are dedicated to finding ways information can be used to helppeople make better and smarter decisions. As a trusted provider of globalinformation solutions, our mission is to help people around the world accessthe opportunities that lead to a higher quality of life, by helpingorganizations optimize their risk-based decisions and enabling consumers tounderstand and manage their personal information. Because when people haveaccess to more complete and multidimensional information, they can make moreinformed decisions and achieve great things.

Everyday TransUnion offers our employees the tools and resources they need to findways information can be used in diverse ways. Whether it is helping businessesbetter manage risk, providing better insights so a consumer can qualify for hisfirst mortgage or working with law enforcement to make neighborhoods safer, weare improving the quality of life for individuals, families, communities andlocal economies around the world.

Weare an equal opportunity employer and all qualified applicants will receiveconsideration for employment without regard to race, color, religion, sex,national origin, age, disability status, veteran status, marital status,citizenship status, sexual orientation, gender identity or any othercharacteristic protected by law.

#LI-EF1


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