Billing Specialist I - FT - Days - MSS - Hybrid Eligible

Job description

At Memorial, we are dedicated to improving the health, well-being and, most of all, quality of life for the people entrusted to our care. An unwavering commitment to our service vision is what makes the difference. It is the foundation of The Memorial Experience. Summary: The Billing Specialist is responsible for resolving claim edits for payors using the knowledge of the appropriate billing form and billing guidelines as well as various insurance contracts and payment methodologies to ensure a compliant claim. Reviews the claims to confirm the correct insurance filling order to ensure the correct payment at the time of initial submission. Ensures compliant billing based on the Office of Inspector General (OIG), CMS, HIPPA and any specific payor regulation. Proactively works accounts to maximize accurate and timely submission of claims utilizing knowledge of all billing guidelines. Responsibilities: Enters all Recovery Audit Contractor (RAC) reviews into the third-party software. Requests medical records and coordinates the response to the RAC request.- for Hospital billingRequests and submits appropriate medical records to selected insurance companies or Medicare either for initia...