Billing Specialist

Role and Responsibilities

The Billing Specialist position is a member of the Billing Team which reports up through the Finance Department. The Billing Specialist is responsible for bill file routing, uploading, error correction, and re-submission.

• Responsible for submitting and receiving all electronic claim files and payer response/rejection files, and for researching and re-submission of claims rejected by clearing house/payer.
• Work pre-post reports prior to submission to ensure claims are correct.
• Initiate and complete enrollment process for payers/providers in medical clearing house.
• Aid in adding and maintaining the HCHB payer setup process.
• Support, maintain, and administer multiple data systems for commercial insurances.
• Daily mapping, testing, processing, monitoring, logistics/order processing support, and reporting.
• Collaborate with manager and Billing Team to help complete billing claim workflows.
• Use appropriate documentation, reference materials, and/or websites to ensure that billing claims are processed accurately and efficiently.
• Maintain and protect confidentiality.
• Ability to read medical electronic claim file segments and loops.
• MS Office experience, especially Excel (2010+).
• Knowledge and understanding of Explanation of Benefits (EOB).

Qualifications and Requirements

• Three to five (3-5) Years healthcare-related experience in billing, claims submission, or prior IT role.
• Team player mentality.
• Ability to work independently.
• Ability to organize, multi-task, and prioritize workload effectively.
• Must possess strong computer and communication skills.
• Understanding of HCPCS, ICD-10, and procedure codes.
• Demonstrated ability to maintain and protect confidentiality.
• Ability to read medical electronic claim file segments and loops.

Education Requirements

• A high school diploma or GED is required.
• An associate's degree is preferred.

Physical Requirements

• While performing the duties of the job the employee is regularly expected to: Stand, Sit, Hear, Walk, Talk, Stoop or kneel, and Repetitive motion.

Work Environment

The Billing Specialist is primarily in an office setting and may be exposed to outdoor conditions. The working conditions are classified as light work: Light work - Exerting up to 20 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Light work involves sitting most of the time.

Other duties as assigned.

EEO/AA Minority / Female / Disability / Veteran