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Memorial Hermann Health System

Senior Hospital Billing Rep - Commercial

Houston, Texas

Overview

Welcome to Memorial Hermann where each of our more than 27,000 employees and 6,700 affiliated physicians share a commitment to helping one another, our patients and our communities. Here, you’ll work alongside the best professionals in the business with the goal of providing the best care possible. We offer an employment experience like no other, and we’ve proudly served this community for more than 110 years. At Memorial Hermann, the health of our community is always at the center of what we do.

  • Job Type: Full-Time, Part-Time
  • Job Level: Senior
  • Travel: Varies by role
  • Glassdoor Reviews and Company Rating Glassdoor Reviews and Company Rating

SUCCESS PROFILE

What makes someone successful at Memorial Hermann?
Check out the top traits we're looking for and see if you have the right mix.

  • Analytical
  • Collaborative
  • Detail Oriented
  • Personable
  • Insightful
  • Helpful

Quote

It is so exciting to work for a company that truly sticks to their vision and values in terms of how we deliver patient care every day. We are constantly looking at ways to improve the lives of those in our communities, and that is what excites me the most.

– Julie B., PBS Manager

TOTAL REWARDS

  • Health Insurance

  • Retirement Plan

  • Paid time off

  • Certification reimbursement

  • Tuition reimbursement

  • Student Loan Repayment

JOB DESCRIPTION

Title Senior Hospital Billing Rep - Commercial Location 909 Frostwood, Houston, TX 77024 Category Revenue Cycle Type Full time Requisition 100111593 Date posted 07/29/2021

At Memorial Hermann, we’re about creating exceptional experiences for both our patients and our employees. Our goal is to provide opportunities for our diverse employee population that develop and grow careers in a team-oriented environment focused on patient care.

Every employee, at every level, begins their journey at Memorial Hermann learning about the history of the organization and its established culture built on trust and integrity. Our employees drive this culture, and we want you to be a part of it.

Job Summary

Position is responsible for analyzing patient accounts, researching account history and determining the appropriate information for billing patients’ third party insurance carriers within a specific time period.

Job Description

The Senior Hospital Billing Representative is responsible for hospital billing for services rendered across the Memorial Hermann system. The main responsibilities include resolving claim rejections/billing edits. The ideal candidate should have Hospital Billing experience.
Desired Skill Sets:
  • An experience Hospital Biller - minimum of 3yrs experience
  • The ability to interpret and analyze billing/payor edits
  • Knowledge of UB04 and Professional form
  • Ability to collaborate with other departments
  • Familiar with and able to maneuver through insurance websites

Minimum Qualifications

Education: (None)

Licenses/Certifications:  (None)

Experience / Knowledge / Skills:

  • Three (3) years hospital/medical insurance billing experience involving public contact, use of computers and related software, medical terminology and forms completion
  • Must have knowledge of third party billing procedures as well as state and federal regulations governing billing
  • Proficient PC skills including: Microsoft Word processing, Excel spreadsheet data entry & construction of new data sheets, Access database, Microsoft Outlook, Electronic Billing system, Imaging software and calculator by touch
  • Must have strong analytical and problem solving skills, statistical analysis, maintaining intense concentration, and the ability to handle multiple priorities and/or special projects
  • Demonstrates commitment to the Partners-in-Caring process by integrating our culture in all internal and external customer interactions; delivers on our brand promise of “we advance health” through innovation, accountability, empowerment, collaboration, compassion and results while ensuring one Memorial Hermann.

Principal Accountabilities

  • Prepares third party billing of Medicare, Medicaid, Blue Cross, Champus, HMO’s, PPO’s, POS’s Workers’ Compensation and Special Contracts.  Remain current on changes in billing and payment requirement for all third party payers. Prepare billing for recurrent accounts, Audit treatment and/or encounter dates for Medicare and Medicaid claims to ensure the 72 hr and Lab compliance rules not violated. 
  • Analyzes accounts for errors, adjustments and credits, issuing corrected entries when necessary.  Updates account information accordingly.
  • Communicates with other hospital departments:  Medical Records, Business Office, Accounting, Labs, Physical Therapy, Infusion suites, Radiology and Materials Management to clarify coding or charges needed to complete billing process.  Call Insurance Companies and/or patients to obtain missing or necessary information to complete the billing process.
  • Maintains working knowledge of ICD9 and CPT4 codes for specified services rendered
  • Monitors regulations set in place by compliance programs to maintain conformity.  Review treatment and/or encounter dates for Medicare & Medicaid claims to ensure compliance of governmental regulations.
  • Utilizes computer skills of various software packages: Microsoft Office, Excel, Word, Power Point Electronic billing, System on-line reporting programs, Electronic Mail, data base management and systems/mainframe/file server applications.  Utilize TDH online Medicaid eligibility systems to verify correct recipient numbers and Medicare DDE online system to verify information prior to billing, enter a correction or void claims.
  • Prepares daily, weekly and monthly reports , maintain and monitor 72 hour reports, lab compliance reports, error forms, return mail procedures, productivity reports and other departmental reports. 
  • Mentors and serves as a resource for less experienced staff.
  • Assists with the development of policies and procedures.
  • Ensures safe care to patients, staff and visitors; adheres to all Memorial Hermann policies, procedures, and standards within budgetary specifications including time management, supply management, productivity and quality of service.
  • Promotes individual professional growth and development by meeting requirements for mandatory/continuing education, skills competency, supports department-based goals which contribute to the success of the organization; serves as preceptor, mentor, and resource to less experienced staff.
  • Other duties as assigned.
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