Billing Specialist

JOB SUMMARY

Responsible for submitting claims and following up with insurance companies on outstanding AR.

POSITION GOAL

Full-time, goal-oriented, revenue-driven, highly accurate and motivated biller who will establish and maintain strong relationships with providers, clients, patients and fellow staff.

SCHEDULE/COMPENSATION

Excellent and competitive benefits package offered which includes medical, dental, vision, disability and life insurance.   Company matching retirement plan and generous paid time off to include vacation and sick leave accruals starting from the date of hire.

RESPONSIBILITIES

• Process electronic medical claims submission five (5) days per week, review for errors and completeness and make necessary corrections. Ensure electronic claims are received by ClaimRemedi.  Update “Claims Transmitted Daily” report.
• Work claim rejection report from ClaimRemedi on a weekly basis.
• Process paper claims per payer requirements on a daily basis. Identify, correct, and rebill errors when necessary. Ensure copies of all paper claims are included in daily CORR batch.
• Review insurance and patient correspondence acquire information to respond to request, and follow up accordingly. Document all information in the “Notes” tab related to the visit and file all copies in daily CORR batch.
• Follow-up on outstanding third-party A/R on a monthly basis as assigned by supervisor. This includes phone calls and/or written correspondence and appeals.  Document collection activities in the “Notes” tab related to the visit. Ensure copies of all appeals and attachments are included in daily CORR batch.
• Report any trends identified while working insurance correspondence and A/R to supervisor.
• Assist front office team by reviewing patient accounts for balances and explanation when requested.
• Take incoming calls from patients and insurance. Document all phone calls on the “Notes” tab related to the visit in question.
• Serve as a backup for charge entry when requested by supervisor.
• Work any special projects or assignments as requested by supervisor.

MINIMUM QUALIFICATIONS

• High School Diploma.
• Bilingual in English and Spanish preferred.
• One (1) year experience in medical claims processing.
• Typing skills 35-40wpm required.
• Knowledge of CPT, ICD-10 codes, and medical terminology required.
• Knowledge of insurance requirements, reimbursement processes, and the ability to understand EOBs required.
• Good telephone etiquette and organizational skills.
• Able to handle diversified duties.
• Must be computer literate and have the aptitude to learn new programs as changes occur.

TYPICAL PHYSICAL DEMANDS

The physical demands described herein are representative of those that must be met by a staff member to successfully perform the essential functions associated with this position. Because we are committed to inclusion of those with disabilities, reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions associated with their position.

• Carrying: Transporting an object, usually by hand, arm or shoulder.
• Lifting: Raising or lowering an object 25-50 pounds.
• Repetitive Motions: Making frequent movements with a part of the body.
• Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
• Talking: Expressing or exchanging ideas by means of the spoken word; those activities where detailed or important spoken instructions must be conveyed to other workers accurately, loudly, or quickly.

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