Billing/Collections Specialist

Billing and Collection Specialist

The Billing and Collection Specialist will be responsible for accurate, timely, and complete documentation regarding insurance verification, billing and collections.

• Prepares and monitors monthly billing and collection processes utilizing established policies, procedures, and tracking systems
• Verifies Medicare, Medicaid and Commercial benefits and prior authorizations
• Identifies deductible, co-insurance and co-pay due per EOBs received
• Compiles appropriate information for refunds, bad debt write-offs, and adjustments
• Typing, assembling, copying, filing and processing data required in an accurate and timely manner
• Making telephone calls, writing letters, and/or sending faxes to patients, insurance carriers, and other responsible parties in the pursuit of getting a claim resolved
• Handling and interpreting medical documentation such as UB04 claim form, 1500 claim forms and EOB’s
• Analyzing and interpreting documents, contracts, notes, and other correspondence
• Writing appeals to insurance carriers to overcome denials
• Managing an extensive portfolio of claims by prioritizing and organizing time effectively
• Complying with privacy laws and patient's needs
• Overcoming obstacles by using effective information gathering and problem-solving methods
• Participating in monthly AR reviews with Management Team

Education/Experience/Skill Requirements

• A high school diploma or equivalent required
• Three or more years' experience in related field required
• Extensive knowledge and understanding of Commercial Insurance and Medicare/Medicaid required