Job Summary:
The Hospital Billing Associate is responsible for preparing, reviewing, and submitting accurate hospital claims using the UB-04 form. This role ensures timely reimbursement from government and commercial payers while maintaining compliance with healthcare regulations.
Key Responsibilities:
- Review patient accounts for accuracy and completeness before claim submission.
- Prepare and submit claims using the UB-04 format.
- Work with insurance companies to resolve denied or unpaid claims.
- Verify correct coding (ICD-10, CPT/HCPCS) and billing modifiers.
- Collaborate with coding, admissions, and medical records departments as needed.
- Monitor and follow up on accounts receivable.
- Assist in identifying and correcting billing errors.
- Maintain knowledge of payer guidelines and regulatory requirements.
Qualifications:
- High School Diploma or equivalent (Associate's degree preferred).
- 1–5 years of experience in hospital billing, with emphasis on UB-04 claim processing.
- Knowledge of Medicare, Medicaid, and commercial insurance guidelines.
- Familiarity with EHR and billing systems (e.g., Epic, Cerner, Meditech).
- Detail-oriented with strong problem-solving skills.
- Ability to work independently and meet deadlines.
