Remote) Hospital Billing Representative

MEDHOST, a division of Harris, is seeking a Hospital Billing Representative to support front‑end hospital billing and clean claim submission for insurance payers, including Medicare, Medicaid, Blue Cross, commercial payers, and other government entities.

Must not work in accounts receivable, collections, denial management, payment posting, patient balance follow‑up, or backend account follow‑up.

• Coordinate daily front‑end hospital billing activities to review, correct, and submit hospital claims accurately to insurance payers.
• Submit initial hospital claims through billing clearinghouses and payer systems.
• Review and resolve front‑end claim edits before claims are released to payers.
• Correct billing issues related to diagnosis codes, procedure codes, charge codes, payer requirements, demographics, authorization details, or claim formatting.
• Work claim edit queues, rejected claim files, Delta‑Delta‑E (DDE) claims, late charge claims, rebills, corrected claims, and shadow claims as assigned.
• Maintain a high clean claim rate by ensuring claims meet payer billing guidelines before submission.
• Use hospital billing software and third‑party clearinghouses to process and monitor claims at the submission stage.
• Keep knowledge of all software applications related to hospital billing and claims submission.
• Recall facility rebills within 7 business days and record comments on patient accounts.
• Communicate issues that impair billing to the Team Lead or Manager.
• Correspond with hospitals, internal teams, and payers to gather mandatory information for claim corrections and resubmissions.
• Partner with other teams and departments to resolve billing, payer, clearinghouse, or claim submission issues.
• Submit billing and rebilling requests from customers and team members in a timely manner.
• Stay current with private and government payer billing practices, software applications, and clearinghouse requirements.
• Assist in training and educating new and existing employees.
• Play an active role in implementing MEDHOST’s Quality Management System and meeting applicable regulatory obligations.
• Accurately record worked time by departmental deadlines.
• Maintain knowledge of MEDHOST core products and third‑party clearinghouses.
• Self‑study and pursue mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mandatory mand.

• High School diploma or equivalent.
• Minimum 1 year of front‑end hospital billing experience.
• Minimum 1 year of experience submitting hospital claims through billing clearinghouses.
• Minimum 1 year of experience using hospital claims management or billing software.
• Must have resolved front‑end claim edits before payer adjudication.
• Experience working with institutional hospital claims, payer billing requirements, clean claim submission, rebills, corrected claims, late charges, DDE claims, and claim edit resolution.
• Must know how to use clearinghouses such as SSI, Availity, Waystar, Change Healthcare, True Bridge, or Quadax.
• Must identify claim errors before submission and take mandatory mandatory mandatory mandatory mandatory mandatory…