Tandem Hospital Partners works with leading hospital systems across the U.S. to build and operate state-licensed, CMS-accredited, acute care neighborhood hospitals. These next-generation hospitals offer convenient, 24/7 neighborhood access to high quality, compassionate emergency and inpatient care, offering low wait times and an exceptional patient experience.
Tandem’s strong clinical, retail, and hospital experience establishes us as the preferred partner in this emerging, innovative industry segment with the most experienced, collaborative, values-driven leadership team. By partnering with Tandem, hospitals can meet the growing demand for emergency and inpatient services in communities where they are currently underrepresented, providing more convenient access to high quality, integrated and patient-centered care.
Job Opportunity – Medical Billing Specialist
Prepares and submits clean claims to various insurance companies either electronically or by paper
Knowledge of physician (CMS-1500) and facility billing (CMS-1450/UB-04)
Reviews claims issues, makes corrections as needed and rebills. Utilizes claims clearinghouse to review and correct claims and to resubmit electronically as needed
Daily review of all postings before claim submission
Daily closing and balancing of day posted
Responsible for evaluating bill cycles and changing/updating when necessary
Responsible for providing daily billing reports – both electronic and paper claims. Monitor validation percent
Responsible for reviewing claim (837 EDI Health Claims & Equivalent Encounter Information) files receipt and response reports
Maintain billing files/records by batch in accordance with established protocol
Work daily claims rejection lists in billing software and clearinghouse queues; set claim(s) to rebill as needed
Answers questions from patients, clerical staff and insurance companies
Identifies and resolves patient billing complaints
Prepares, reviews and sends patient statements
Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts to Manager
Maintains strictest confidentiality; adheres to all HIPAA and PHI guidelines/regulations
Meets all month end closing processes to ensure billing is completed on a timely basis
Participates and attends monthly staff meetings
Knowledge, Skills and Abilities
Downtown, Houston, TX
Up to 25% depending business needs
If you are applying for a position in the United States, you must be at least 18 years of age, legally authorized to work in the United States, and not require sponsorship for employment visa status (e.g. TN, H1B status), now or in the future.
Tandem Hospital Partners strongly values diversity and is committed to equal opportunity and non-discrimination in all of its policies and practices, including the area of employment. THP is proud to be an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, national origin, age, disability, Veteran status, gender identity or expression, genetic information or any other legally protected status. We maintain a drug-free workplace and perform pre-employment substance abuse testing.
The essential functions listed are typical examples of work performed by positions in this job description and are not designed to contain or be interpreted as a comprehensive inventory of all duties, tasks and responsibilities. Specific duties and responsibilities may vary depending on department or program needs without changing the general nature and scope of the job or level of responsibility. Employees may also perform other duties as assigned.
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
as well as possession of any required licenses or certifications is qualifying.