Billing Specialist I

Billing Specialist

Key Responsibilities

• Audit emergency department (ER) registration documentation to verify the accuracy of patient demographics, insurance coverage, and eligibility information.
• Provide ongoing feedback, coaching, and education to registration staff regarding registration accuracy, insurance verification, and documentation requirements.
• Identify trends and recurring registration errors and recommend process improvements to reduce claim denials and billing delays.
• Investigate and follow up on denied insurance claims, determine root causes, and take corrective action to secure reimbursement.
• Collaborate with patients, insurance companies, registration teams, clinical departments, and other internal stakeholders to obtain, update, and correct demographic and insurance information.
• Ensure insurance information is accurate and up to date in the billing and registration systems.
• Document denial resolutions, registration corrections, and audit findings in accordance with organizational policies.
• Maintain knowledge of payer requirements, insurance regulations, and billing best practices.
• Assist with special projects and revenue cycle initiatives as assigned.

Qualifications

• Education: High School or GED, required.
• Experience: Work experience in medical billing or hospital coding, claims processor- preferably medical claims for an insurance carrier, or Clerical/Billing experience in a medical office, 1 yr experience required.
• Licensure/Certification: Certified Medical Billing/Coding, preferred.