Hospital Billing Operator
- Review patient accounts, charge details, coding inputs, and supporting documentation for billing accuracy and completeness
- Prepare and submit hospital claims to commercial, government, and other third-party payers in accordance with payer requirements
- Validate claim data for demographics, insurance coverage, authorizations, provider information, modifiers, and coding-related elements; identify and correct claim edits, rejections, and billing errors before submission or rebilling
- Work with coding, registration, authorization, clinical, and accounts receivable teams to resolve billing issues, prevent avoidable denials, and submit supporting documentation required by payer guidelines
- Adhere to defined standard operating procedures and workflows while working in Epic Resolute Hospital Billing, claims clearinghouse systems, payer portals, and related tools; monitor work queues and reports, support complex claim resolution, and meet productivity and quality standards
- Ability to work independently and collaborate as part of a team
- Effective written and verbal communication skills
- Meticulous attention to detail and quality of work product
- Ability to build and sustain professional relationships
- Ability to lead projects or workstreams
- Ability to manage and prioritize multiple tasks in a fast-paced and dynamic environment
- Strong interpersonal skills and professional demeanor
- Ability to meet deadlines
- Ability to provide clear guidance to others
- Bachelor's degree in information technology, business, healthcare, or a related field; or equivalent experience
- 2+ years of experience in hospital billing operations
- Experience using Epic Resolute Hospital Billing
- Experience working in claims clearinghouse systems
- Experience using Epic Analytics and Reporting applications
- Ability to travel 10%, on average, based on the work you do and the clients and industries/sectors you serve.
- Limited immigration sponsorship may be available.
- Experience using Microsoft Word, Excel, and PowerPoint
- Experience supporting clinical or healthcare business operations
- Experience managing multiple projects or workstreams
- Experience preparing and delivering technical demonstrations
- Experience analyzing billing workflows, claim issues, or operational data
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