Billing/Follow-up Specialist - Professional Billing

Job Summary

Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote financial health. This position ensures appropriate reimbursement and days in Accounts Receivable with timely account follow-up and resolution of outstanding charges owed by third party payors. Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization.

Essential Functions

• Solves insurance claim rejections/denials, and non-payment of claims by payors.
• Identifies trends in billing and follow-up, in order to expedite resolution of insurance accounts and identify delays in processing.
• Drafts appeals to insurance companies for reimbursement of monies owed.
• Maintains daily account, follow-up work lists within department while maintaining organization’s productivity standards.
• Ensures compliance and claims processed in accordance with payer contracts and policies, as well as to settle claims as appropriate.
• Identifies, researches and resolves: credit balances, missing payments, payer recoupments, and unposted cash as it pertains to billing account follow-up.
• Processes and maintain correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.
• Handles submission of issues to coding for review to ensure organizational and revenue cycle processes are followed.
• Communicates appropriately with insurance companies, patients, co-workers and supervisors.
• Performs other duties as assigned.

Qualifications

• Education: High School Diploma Required; Associate Degree Preferred.
• Experience: Minimum of 2 years Required; Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered.
• Knowledge: Medical terminology experience; Knowledge of insurance processes and billing guidelines regulations.
• Credentials: Medical Billing Certificate or Certified Revenue Cycle Representative or HealthStream Badge.
• Skills: Proficient use of computers including Microsoft Office applications (Word, Excel, PowerPoint, etc.); 10-key by touch and keyboarding; Ability to operate general office equipment; Excellent verbal and written communication skills; Excellent attention to detail and ability to multi-task; Strong organizational skills with the ability to prioritize and meet deadlines; Knowledge of Commercial and/or Government Payors; Ability to identify, research, and resolve credit balances, missing payments and unposted cash and payer recoupments, as it pertains to billing account follow-up.

Working Conditions

• Lifting: Consistently operates computer and other office equipment. Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects. Sedentary work.
• Environmental Conditions: Predominantly operates in an office environment.
• Mental/Visual Ability: Close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.

Benefits

• Full medical/dental/vision coverage.
• 403b retirement plan employer base and matching contributions.
• Paid time off.
• Employer-paid life and disability insurance with additional buyup coverage options.
• Tuition and continuing education reimbursement.
• Wellness benefits, and expanded EAP and mental health program.