Gotham

Billing Representative-Cardiovascular- Full Time

Henry Ford Health St. John Hospital

Detroit, Michigan

Full-time | Remote

Work facility: Not Specified

Job Description

Schedule: Monday-Friday day shift-100% remote

Determines and verifies insurance coverage and coordination of benefits from all sources for assigned area. Ensures proper adequate and timely billing to ensure prompt payment.

Responsibilities:

  • Confirms insurance coverage. Determines necessity for pre-authorization and obtains authorization for scheduled procedures.
  • Determines financial responsibility for services to be provided. Notifies patients and/or practitioners of any services requested and/or referred that are not authorized by insurance.
  • Communicates with patients and practitioners regarding financial responsibility and insurance coverage issues.
  • Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
  • Prepares and completes claims for commercial insurance companies, third party organizations and/or government or self payers.
  • Researches, analyzes and reconciles Medicare/Medicaid billing and reimbursement practices.
  • Maintains detailed documentation in the patient account record of all billing activities. Maintains documentation of claims processed as part of the daily claims reconciliation process.
  • Consults with appropriate parties to resolve unbilled claims.
  • Reviews recent accounts for proper billing practices and reimbursement. 

 EDUCATION/EXPERIENCE REQUIRED 

  • High School diploma equivalency OR 1 year of applicable cumulative job specific experience required
  • Medical billing experience preferred
Additional Information
  • Organization: Henry Ford Health St. John Hospital
  • Shift: Day Job
  • Union Code: Not Applicable