Billing Specialist

Key Responsibilities

• Prepares and submits medical and dental claims to Medicaid, Medicare, commercial insurance and private pay patient accounts.
• Analyzes rejected claims, corrects errors, and resubmits claims to payer for payment.
• Updates information in software on patient accounts when new information comes available.
• Posts reimbursement checks in software as received.
• Analyzes denied claims, submits corrected claims when necessary, and reports anomalies to supervisor.
• Works with third party payers on billing problems, denials and requests for information.
• Communicates with patients regarding issues affecting payment such as coordination of benefits, third party payers, Medicare replacement plans, and primary care physicians.
• Researches outstanding claims, corrects errors, communicates with payer, and resubmits for payment.
• Handles patient billing complaints professionally and expeditiously.
• Prepares financial records for release when requested and authorized.
• Has knowledge of sliding scale discount procedures and adjusts accounts as necessary.

Required Qualifications

• A high school diploma or equivalent required.
• Medical billing certification (especially CPC) preferred.
• Bilingual Spanish/English is preferred.