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Billing Specialist- Governmental

locationVermont - Vermont (VT),

atChange Healthcare

Job Description:

Billing Specialist – Governmental

Overview of Position

Possess and apply thorough knowledge to all aspects of facility billing process including eligibility, coding, and insurance/payer requirements.

What will be my duties and responsibilities in this job?

  • Ensures claim information is complete and accurate by reviewing claims for discrepancies
  • Identify potential issues as it relates to coding or insurance requirements and work with client to correct errors
  • Monitor claim submission statistics via generated reports
  • Follows up with insurance companies on unpaid or rejected claims to determine and resolve any outstanding issues and re-submit corrected claims if necessary
  • Investigate, verify, and analyze patient’s eligibility results for any medical coverage and obtain proper billing contact information
  • Request or obtain documentation where applicable
  • Enters information necessary for insurance claims such as patient, insurance, provider, as well as diagnosis, treatment codes and modifiers if applicable.
  • Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB-04 form or 1500 form.
  • For patients with coverage by more than one insurer, prepares and submits secondary claims upon processing by primary payer
  • Follows HIPAA guidelines in handling patient information

What are the requirements needed for this position?

  • Minimum of 3 years’ hospital revenue cycle experience and knowledgeable on governmental payers (Medicare, Medicaid, and Tricare) – preferably across facility types (Acute, SNF, IRF, LTAC & Cancer
  • Knowledgeable on insurance billing, collections, and reimbursement processes
  • Both hospital and professional fee experience required
  • High school diploma or GED required
  • Must be available to work Monday-Friday, standard business hours, Eastern Time

What other skills/experience would be helpful to have?

  • Florida Medicaid knowledge preferred
  • Assurance and/or Invision experience helpful
  • Strong organizational skills and attention to detail
  • Excellent written and verbal communication skills
  • Ability to work independently with minimal
direction and oversight as well as with a team
  • Ability to handle multiple responsibilities under strict deadlines and prioritize efficiently
  • Ability to navigate through the field locators on the UB 04 confidently and by able look up various field requirements such as modifier, occurrence codes, ICD 10 diagnosis and CPT treatment codes from online services or using traditional coding references
  • Familiarity with HIPAA privacy guidelines and maintains and protects all confidential information
    • What are the working conditions and physical requirements of this job?

    General office demands

    Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!

    Equal Opportunity/Affirmative Action Statement

    Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at and the supplemental information at

    If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to [email protected] with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.

    Click here to view our pay transparency nondiscrimination policy.

    California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information.

    Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.

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