St. Jude Children’s Research Hospital Looking for Senior Insurance Billing Specialist at Memphis, TN  Full Time

As the senior billing staff member, investigates complex payer inquiries, remittance advices, and other billing procedural discrepancies; Analyzes, recommends, and initiates procedural improvements. Leads initiative to instill total quality processes and interchange of ideas among staff.

Job Responsibilities, include but not limited to:

• Completes claims submission electronically for both primary and secondary claims. Utilizes automated editing functions for flagging incorrect ICD-9, CPT-4, and HCPCS codes. Directs special focus toward physician and mid-level services as they relate to insurer-specific standards.

• Utilizes claims editing software and application processes for identifying and correcting claims submission/payment errors.

• Prepares charges for billing and enters data from patient charge tickets. Utilizes scanning technology and/or electronic interfaces, as available.

• Posts line-item payments and adjustments to patient accounts. Utilizes electronic remittance payment process, as available by insurer.

• Follows up with insurance carriers on unpaid/denied claims. Completes and files reconsideration requests to carriers with additional documentation or corrections.

• Researches diagnosis and CPT codes, verifies ancillary charges with physician.

• Recommends and coordinates updates for rules-based insurance utility files.

• Leads initiatives to instill total quality processes, improved communications and interchange of ideas among staff.

Minimum Education and/or Training:

• High School Diploma required

• Associate degree preferred.

Minimum Experience:

• Five (5) years professional fee collection/billing experience directed toward accounts receivable management, automated patient accounts systems, and insurance recovery processes.

• Extensive experience and familiarity with entire revenue cycle process with primary emphasis on medical collection, data entry, claims processing, line-item payment processing, and insurance appeals.

• Accounts receivable management with large volume collection/billing processes desired.

• Familiar with billing/coding process and extensive experience evaluating and operating automated physician-billing systems.

• Experience in a large multi-specialty group practice or academic setting preferred.

• IDX experience a plus.

• (NL) Certified Procedural Coder (CPC) or Certified Coding Specialist preferred.

Have More in Memphis

Get the best of big-city amenities mixed with all the charm of a small-town feel when you live in Memphis. From our world-renowned music scene to our eclectic mix of food and people, Memphis is a place our employees are proud to call home. Our region enjoys a cost of living more than 20% lower than the national average, and our state places no personal income tax on wages. Plus, Memphians spend five hours less per year in their daily commute compared to the national average. Learn how you can “Have More in Memphis.”

St Jude Employees receive:

• Excellent healthcare plans with zero to low health premium costs

• Onsite health clinic, pharmacy, and exercise facilities

• Paid parental leave and adoption assistance

• Immigration Services

• Tuition Reimbursement

St. Jude Children’s Research Hospital has a diverse, global patient population and workforce, built on the principles of diversity, equity and inclusion. Our founder Danny Thomas envisioned a hospital that would treat children of the world-regardless of race, religion or a family’s ability to pay.

Today, we continue the mission to advance cures and means of prevention for pediatric catastrophic diseases through research and treatment. As we accelerate this progress globally, we believe our legacy of diversity, equity and inclusion is foundational to success. With the commitment of leaders at all levels of the organization, we strive to ensure the St. Jude culture, leadership approaches and talent processes are equitable and culturally responsive. View our to learn about the hospital’s roots in diversity, equity and inclusion, where we are today and our aspirations for an even better future.

Other Information

St. Jude Children’s Research Hospital is an Equal Opportunity Employer. St. Jude does not discriminate on the basis of race, national origin, sex, genetic information, sexual orientation, gender identity, transgender status, age, religion, disability, veteran’s status or disabled veteran’s status with respect to employment opportunities. All qualified applicants will be considered for employment. St. Jude engages in affirmative action to increase employment opportunities for minorities, women, veterans and individuals with disabilities.