Insurance Billing Specialist, Full-time

Responsibilities

• Insurance Claim Billing: Reviews patient accounts and verifies data for correct billable services and fees. Ensures all pertinent billing information is documented to produce a clean UB-04 claim. Runs daily insurance billing reports and reviews discrepancies. Corrects accounts, as necessary. Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes. Prior to submission, reviews each claim for accuracy and missing information. Transmits claims electronically to TruBridge.
• Insurance Claim Follow up: Follows up on any unpaid claim. Follows-up on insurance denials and takes appropriate steps to resolve discrepancies. Communicates discrepancies and the need for additional information to the appropriate parties. Obtains supporting documentation to appeal claim payment. All collection and follow-up efforts will be annotated in the CPSI computer System. Re-bills accounts as needed.
• Audit Payments: Receives daily incoming payments and prepares for posting. Reviews explanation of benefits and verifies patient information, payer, and date of service for all transactions. Audits payments against contract terms. Computes contractual allowances as needed. Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off. Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.
• Accounts Receivable Management: Monitors and maintains assigned Accounts Receivable at minimal levels. Ensures any credit balances are resolved and generates refund requests for over payment as soon as possible.
• Other Duties as Assigned: Keeps updated on all third-party billing requirements. Serves as a resource person for staff inquiries regarding billing issues. Assists with training of staff as necessary. Other duties as assigned.

Knowledge/Skill/Ability Requirements

• Minimum of High School Diploma. Some college preferred.
• Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.
• Knowledge of medical billing /collection procedures.
• Prefers 1-2 years in medical business office including Insurance Claim follow up.
• Demonstrated working knowledge of a computerized medical information management system.
• Skills in Microsoft Office Suite (Word, Excel, Outlook).
• Good verbal and written communication skills required.
• Ability to work independently with only general supervision.
• Great attention to detail required along with a high level of dependability.
• Excellent telephone techniques and rapport.
• Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.

Pay Range

$18 - $23 per hour