Billing Specialist-Emergency Department-FT-1st shift

Responsibilities

• Ensures accurate billing and timely submission of electronic and/or paper claims.
• Maintains monitoring of claim status and researches rejections and denials.
• Documents related account activities and analyzes expected reimbursement information.
• Collects payments from government and commercial insurance payers.
• Reviews Explanation of Benefits (EOB) documents and determines accurate account balances.
• Determines applicable denial descriptions and appeals processes.
• Must possess a medical billing certification.
• Requires critical thinking skills and understanding of Medicare, Medicaid eligibility requirements, and commercial insurance payer payment methods.
• Responsible for correctly recording contractual adjustments based on payer contracts or government regulations.
• Must demonstrate proficiency with billing systems to ensure optimal claim processing efficiency.
• Must exhibit excellent written and verbal communication skills.

Qualifications

• High school diploma and CCS credentials required.
• In-depth knowledge of medical and anatomical terminology, reimbursement principles, health record content, sequencing of diagnoses, and coding software.