The Cardiac Management Solutions division of ZOLL Medical Corporation develops products to protect and manage cardiac patients, including the LifeVest® wearable cardioverter defibrillator (WCD), the ZOLL cardiac monitor, and associated technologies.
Heart disease is the leading cause of death for both men and women in the U.S. At ZOLL, your work will help to ensure cardiac patients get the life-saving therapy they need. To date, the LifeVest WCD has been worn by hundreds of thousands of patients and saved thousands of lives.
ZOLL has been Pittsburgh’s Manufacturer of the Year, one of Western PA’s Healthiest Employers, and even one of Pittsburgh’s Coolest Offices. But it’s our unique opportunity to impact people’s lives that makes ZOLL the ideal place to build your career.
The Billing Specialist assists with the reimbursement process by reviewing account information to ensure accuracy and completeness in order to generate and create compliant claims.
Essential Duties and Responsibilities:
- Creates all medical claims by reviewing account data and entering into billing software.
- Determines appropriate HCPCS codes, modifiers and other claim specific requirements or special instructions as dictated by payer.
- Confirms all necessary documentation is on file including valid medical orders, Patient Agreement forms, evidence of patient use and authorization as required by payer.
- Creates initial claims as well as all subsequent and replacement claims for the duration of patient use, confirming all data is entered completely and correctly into the billing software.
- Reviews Patient Agreement forms for completeness and compliance prior to claim creation. Also responsible for acceptance or rejection of this form, communicating with external departments as needed to identify and correct errors.
- Requests claim adjustments for various reasons based on but not limited to compliance and documentation.
- Contacts hospitals and other facilities to verify the patient has been discharged to the home prior to initial claim creation as required by payer.
- Responsible for working all assigned account exceptions in order to confirm or obtain complete and correct information needed for claim creation daily.
- Responsible for coding claims appropriately for tracking purposes as instructed by claim requestors.
- Responsible for meeting department standards in relation to production, quality, attendance and carryover as identified, tracked and reviewed on monthly scorecards.
- Responsible for adhering to all company processes and procedures as identified in employee handbook.
- Performs other duties as assigned by Management.
Supervisory Responsibilities: None.
Qualifications: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this job.
Educations and/or Experience:
- H.S. Diploma or equivalent required.
- Minimum 1-2 years of experience in medical billing or certification in Medical Billing and Coding.
- Experience with Microsoft Excel, email programs and online information systems.
- Experience working with all payer types to include Medicare, Medicaid, and third party commercial insurance companies.
Language Skills: Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.
Mathematical Skills: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.
Reasoning Ability: Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
- The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel and talk or hear. The employee is occasionally required to walk. The employee must occasionally lift and/or move up to 10 pounds.
- The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- The noise level in the work environment is usually quiet.
ZOLL is an Equal Opportunity Employer - minorities/females/veterans/individuals with disabilities/sexual orientation/gender identity.