Billing Specialist

Job Responsibilities

• Performs all billing and follow-up functions.
• Ensures accurate and complete charge generation and clean claim submission for both paper and electronic claims on a weekly basis.
• Audits accounts for charge accuracy, duplications and overlapped billing, making any adjustments required.
• Edits claim forms, using instructions for each payer, applying principles of coordination of benefits and ensuring correct diagnoses, procedure codes, etc. are utilized.
• SUBMIT INSURANCE CLAIMS, RESPONSIBLE FOR THE MAINTENANCE OF BILL HOLDS AND THE CORRECTION OF ERRORS TO ENSURE TIMELY AND ACCURATE SUBMISSION.
• RESEARCH CLAIM REJECTIONS, MAKING CORRECTIONS, TAKING CORRECTIVE ACTIONS AND/OR REFER CLAIMS TO APPROPRIATE TEAM MEMBERS FOR FOLLOW THROUGH TO ENSURE TIMELY CLAIM RESOLUTION.
• APPLIES KNOWLEDGE OF SPECIFIC PAYER BILLING AND PAYMENT RULES, MANAGED CARE CONTRACTS, REIMBURSEMENT SCHEDULES, ELIGIBLE PROVIDER INFORMATION AND OTHER AVAILABLE DATA AND RESOURCES TO ENSURE A CLEAN CLAIM.
• EVALUATES ACCOUNTS, RESUBMITS CLAIMS, AND PERFORMS ADJUSTMENTS, WRITE-OFFS AND OR BALANCE REVERSALS, IF CHARGES WERE IMPROPERLY BILLED OR IF PAYMENTS WERE INCORRECT.
• RESPONDS TO INQUIRIES, COMPLAINTS OR ISSUES REGARDING CLIENT BILLING AND COLLECTIONS, EITHER DIRECTLY OR BY REFERRING THE CLIENT TO AN APPROPRIATE RESOURCE FOR RESOLUTION.
• MANAGES UNBILLED, UNBALANCED VISITS, AND OTHER BILLING RELATED REPORTS.
• INFORMS BILLING MANAGER OF ANY CHARGING TRENDS OR CLAIM EDIT/REJECTION TRENDS AND PROVIDES EXAMPLES.
• ASSISTS IN PROVIDING EDUCATION TO OTHER DEPARTMENTS TO REDUCE ERRORS.

Requirements

• High school diploma or GED required but associate or bachelor’s degree preferred.
• PREFERRED EXPERIENCE IN HEALTHCARE REVENUE CYCLE BILLING OR ACCOUNT RECEIVABLE.

Benefits

• MEDICAL, DENTAL, AND VISION BENEFITS (ACCESS TO $0 COST EMPLOYEE MEDICAL PLAN).
• ACCESS TO HSA/FSA ACCOUNTS, DEPENDING ON MEDICAL PLAN ELIGIBILITY (EMPLOYER CONTRIBUTED HSA ACCOUNT).
• EMPLOYER PAID TERM LIFE AND AD&D INSURANCE POLICY AT $0 COST TO EMPLOYEE.
• 401K RETIREMENT THAT INCLUDES EMPLOYER MATCH UP TO 2%.
• GENEROUS PTO PROGRAM WITH WEEKLY ACCRUAL. EMPLOYEES CAN EARN UP TO 200 HOURS ANNUALLY BASED ON YEARS OF SERVICE, STARTING WITH UP TO 120 HOURS PER YEAR FOR EMPLOYEES WITH 0-2 YEARS OF SERVICES.

Pay

This position starts at $27.88 per hour.

Schedule

This position is hybrid - in office Monday - Wednesday and remote Thursday-Friday.