Billing Review Specialist

Job Functions

• Ensures all assigned reviews and company projects are completed timely and accurately according to the scope of work.
• Reports any issues and/or concerns to the Supervisor of the Centralized Billing Review team and/or Manager of the Centralized Billing Review team.
• Contacts payors to discuss policy criteria or ask clarifying questions on accounts.
• Understands payor requirements according to their policies.
• Ensures completion of all forms and collects complete billing information.
• Pursues, maintains, and communicates medical coverage/guideline changes/updates.
• Verifies insurance benefits and eligibility for patients.
• Communicates with patients to resolve billing issues and ensure timely payment.
• Maintains accurate and up-to-date patient records in compliance with HIPAA regulations.
• Works assigned reports accurately and timely.
• Helps facilitate interoffice communication on payor updates and trends.
• Completes any adjustments/transfers of AR as required.
• Drafts documentation of all activity in customer's computer account or applicable applications.
• Answers billing review specialist questions accordingly.
• Reports issues and/or concerns in a timely manner.
• Available to assist other billing review specialists on the team with questions or needs.
• Acts as liaison between staff and management.