Title: Billing & Contract Specialist Fulltime - Remote
Location: USA-
Job Description:
locations
100% Remote
time type
Full time
posted on
Posted Yesterday
job requisition id
R1056094
At Virtua Health, we exist for one reason – to better serve you. That means being here for you in all the moments that matter, striving each day to connect you to the care you need. Whether that's wellness and prevention, experienced specialists, life-changing care, or something in-between – we are your partner in health devoted to building a healthier community.
If you live or work in South Jersey, exceptional care is all around. Our medical and surgical experts are among the best in the country. We assembled more than 14,000 colleagues, including over 2,850 skilled and compassionate doctors, physician assistants, and nurse practitioners equipped with the latest technologies, treatments, and techniques to provide exceptional care close to home. A Magnet-recognized health system ranked by U.S. News and World Report, we've received multiple awards for quality, safety, and outstanding work environment.
In addition to five hospitals, seven emergency departments, seven urgent care centers, and more than 280 other locations, we're committed to the well-being of the community. That means bringing life-changing resources and health services directly into our communities through our Eat Well food access program, telehealth, home health, rehabilitation, mobile screenings, paramedic programs, and convenient online scheduling. We're also affiliated with Penn Medicine for cancer and neurosciences, and the Children's Hospital of Philadelphia for pediatrics.
Location:
100% Remote
Currently Virtua welcomes candidates for 100% remote positions from: AZ, CT, DE, FL, GA, ID, KY, MD, MO, NC, NH, NJ, NY, PA, SC, TN, TX, VA, WI, WV only.
Remote Type:
On-Site
Employment Type:
Employee
Employment Classification:
Regular
Time Type:
Full time
Work Shift:
1st Shift (United States of America)
Total Weekly Hours:
40
Additional Locations:
Job Information:
Summary:
The Billing & Authorization Specialist ensures accurate and timely processing of EMS and Transfer related authorizations, billing, and records management to support patient care and organizational compliance.
This role is responsible for managing pre-certification and prior authorization processes, resolving denied claims, and auditing transportation invoices to verify service levels, insurance coverage, and medical necessity.
The specialist also oversees EMS agency billing activities, coordinates with internal departments and external vendors, and serves as the department’s Keeper of the Records.
Position Responsibilities:
Prepares, verifies, submits, registers and manages the pre-certification and/or prior authorization process for all applicable patient encounters. Utilization of payer websites, faxes, and phone.
Directly manages denied claims working with the insurance companies and Patient Accounting Department.
Reviews, audits and reconciles EMS agency invoices, Medicaid trips and prepares requisitions for payment, coordinating with Billing Manager, legal office, Accounts Payable and Purchasing.
Reviews invoices from non-Virtua transportation agencies related to interhospital and discharge transport. Audits invoices to ensure proper level of service, insurance authorization and medical necessity. Interacts with Hospital management, and Case Management and Patient Accounting when necessary to approve payment for certain transport.
Functions as Department “Keeper of the Records” and interacts with internal HIM and legal staff, external law offices, and patients in the handling and processing of all subpoenas and requests for medical records.
Position Qualifications Required:
Required Experience:
2-3 years of EMS registration coding and billing experience required.
2-3 years Insurance Authorization experience required.
Understanding of third-party reimbursement and methodologies for all third party payers, especially pre-certification and COB regulations.
Working knowledge MS Excel as well as various PBS related applications or demonstrated computer proficiency with ability to learn new applications as required.
Required Education:
High School Diploma required.
Training / Certification / Licensure:
Certified Heath Care Access Associate (CHAA) certification required within first year in position.
Hourly Rate: $22.46 - $33.71 The actual salary/rate will vary based on applicant’s experience as well as internal equity and alignment with market data.
Virtua offers a comprehensive package of benefits for full-time and part-time colleagues, including, but not limited to: medical/prescription, dental and vision insurance; health and dependent care flexible spending accounts; 403(b) (401(k) subject to collective bargaining agreement); paid time off, paid sick leave as provided under state and local paid sick leave laws, short-term disability and optional long-term disability, colleague and dependent life insurance and supplemental life and AD&D insurance; tuition assistance, and an employee assistance program that includes free counseling sessions. Eligibility for benefits is governed by the applicable plan documents and policies.
