Central Billing Office Professional
Company: Highmark Health
Posted on: November 14, 2023
Allegheny Health Network
Job Description :
This job is responsible for providing support, covering all aspects
of insurance billing, claims follow up and collections, including
direct contact to the appropriate third-party payers for all unpaid
claims including denied claims and those requiring appeal.
Ensures efficient processing of billing claims, insurance follow
up, collection activities and denials. Assists in meeting cash
collection goals by reviewing, completing, and submitting
appropriate documentation based on payer requirements. Conducts
research and provides updates and current status of collection
efforts using the appropriate data management system
Performs billing, follow-up and collection functions for third
parties, resolving issues that impact or delay claims payment.
Communicates information and ideas to make system-wide process
improvements. Updates data regarding changes and modifications in
plan benefits and other contract information relevant to the
billing or claims follow up and collection process.
Serves as support staff for various departments and external payers
by developing positive relationships with managed care
organizations and outside agencies, and clinical areas within the
organization. Reviews and responds to correspondence and inquiries
generated by third party payers. Provides medical record copies and
other pertinent information to the appropriate sources throughout
the billing and collection process. Works collaboratively to
facilitate the insurance billing and collections process to improve
overall cash collection.
Supports overall Revenue Cycle processes to achieve established
targets and goals, including the completion of special/specific
assigned projects or tasks.
Monitors the status of denials, appeals, and claim errors by using
folders/work queues and conducting routine, periodic follow up on
previously researched claims items. Monitors, reviews, and suggests
revisions or updates to existing forms, documents, and processes
required to facilitate timely billing and collections.
Ensures completeness of claims by following national, local, and
internal billing requirements promoting prompt and accurate
submission and payment. Maintains awareness of current regulations.
Initiates practices that support current regulations.
Performs other duties as assigned or required
- Health care experience of up to 3 years
- Associate's Degree/completion of college level coursework
Disclaimer: The job description has been designed to indicate the
general nature and essential duties and responsibilities of work
performed by employees within this job title. It may not contain a
comprehensive inventory of all duties, responsibilities, and
qualifications required of employees to do this job.
Compliance Requirement : This job adheres to the ethical and legal
standards and behavioral expectations as set forth in the code of
business conduct and company policies.
As a component of job responsibilities, employees may have access
to covered information, cardholder data, or other confidential
customer information that must be protected at all times. In
connection with this, all employees must comply with both the
Health Insurance Portability Accountability Act of 1996 (HIPAA) as
described in the Notice of Privacy Practices and Privacy Policies
and Procedures as well as all data security guidelines established
within the Company's Handbook of Privacy Policies and Practices and
Information Security Policy.
Furthermore, it is every employee's responsibility to comply with
the company's Code of Business Conduct. This includes but is not
limited to adherence to applicable federal and state laws, rules,
and regulations as well as company policies and training
Pay Range Minimum:
Pay Range Maximum:
Base pay is determined by a variety of factors including a
candidate's qualifications, experience, and expected contributions,
as well as internal peer equity, market, and business
considerations. The displayed salary range does not reflect any
geographic differential Highmark may apply for certain locations
based upon comparative markets.
Highmark Health and its affiliates prohibit discrimination against
qualified individuals based on their status as protected veterans
or individuals with disabilities, and prohibit discrimination
against all individuals based on their race, color, age, religion,
sex, national origin, sexual orientation/gender identity or any
other category protected by applicable federal, state or local law.
Highmark Health and its affiliates take affirmative action to
employ and advance in employment individuals without regard to
race, color, age, religion, sex, national origin, sexual
orientation/gender identity, protected veteran status or
EEO is The Law
Equal Opportunity Employer Minorities/Women/Protected
Veterans/Disabled/Sexual Orientation/Gender Identity (
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Req ID: J233925
Keywords: Highmark Health, Lansing , Central Billing Office Professional, Administration, Clerical , Lansing, Michigan
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