Billing Specialist-Emergency Department-FT-1st shift

About the role

The Certified Billing Specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, analyzing expected reimbursement information and collections of government and commercial insurance payers. Additionally, reviews EOB’s and determines accurate account balance, detailed denial description, and applicable appeal process.

Responsibilities

• Ensures accurate billing and timely submission of claims
• Maintains monitoring of claim status and researches rejections and denials
• Documents related account activities and analyzes expected reimbursement information
• Reviews EOB’s and determines accurate account balance, denial description, and applicable appeal process

Requirements

• Medical billing certification required
• Must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods
• To correctly record contractual adjustments based on payer contracts or government regulations
• Must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims

Qualifications

• Education: High school diploma and CCS credentials
• Experience: In-depth knowledge of medical and anatomical terminology, reimbursement principles, health record content, sequencing of diagnoses, and the use of coding software