Insurance Billing Specialist

80 hours per pay period, full-time days.

About the role

The Insurance Billing Specialist accurately and promptly reviews and updates claims needing manual intervention prior to claim submission, submits claims to insurance carriers, follows up on the status of unpaid claims, works denied claims to resolve any errors or provides necessary information to payers needed for disputing or resubmitting. This position requires routine problem solving and handles inquiries from both insurance carriers and patients, with a goal of account resolution.

Responsibilities

• Reviews, edits, and corrects claims, as necessary, checking for accuracy and readiness of claims to be submitted through the electronic health record (EPIC).
• Prepares and submits claims to insurance carriers and intermediaries, i.e. releasing electronic claims, printing paper claims, and/or secondary claim as required per individual payer.
• Works with various departments to ensure that held claims will be released to the payer within timely filing limits.
• Performs follow-up procedures, inquiring on the status of unpaid claims via phone call or various payer portals, to ensure timely payment of insurance claims.
• Responds to routine patient and insurance company inquiries and problems.
• Researches denials/non-covered charges and re-submits or appeals, as necessary.
• Reviews late charges for re-billing or adjustment of claims, as necessary.
• Reviews insurance eligibility or coverage changes to ensure accuracy of information, resolve any outstanding issues, and rebill claims when necessary.
• Updates necessary changes to patient demographics and/or insurance information.
• Reviews accounts with insurance credit balances and determines if a refund or other action is necessary to settle account.
• Accommodates patient requests and inquiries promptly and courteously, answering incoming calls to the Business Office, educating patients on their financial responsibilities to the organization, accepting payment, setting up payment plans, etc.
• Performs other duties as deemed necessary for the continued viability and success of the department and organization as a whole.

Skills

• Accountability – Ability to accept responsibility and account for actions.
• Communication – The ability to convey ideas effectively through oral or written means and to understand others through active listening.
• Customer Oriented – Ability to address customer needs while adhering to company procedures.
• Detail Oriented – Ability to focus on minute details of tasks or projects.
• Organized – Ability to follow a systematic method in performing tasks.
• Ethical – Ability to demonstrate conduct conforming to accepted standards and values.
• Accuracy – Ability to perform work thoroughly and precisely.
• Reliability – Dependability and trustworthiness in performing duties.
• Research Skills – Ability to conduct systematic, objective, and critical investigations.

Requirements

• High School Graduate or General Education Degree (GED): Required
• Associate’s Degree (two-year college or technical school) Preferred, Field of Study: Business Related
• 1-2 years of healthcare billing experience preferred
• 1-2 years of EPIC experience preferred
• Microsoft Office proficiency

Benefits

• Competitive pay
• Medical, dental, and vision insurance
• Life insurance
• Short-term disability
• Paid time off
• Retirement plan with company match