Specialist-Billing

About the role

Responsible for the daily completion of claims edit, denial, and no-response billing functions for timely follow-up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Performs other duties as assigned.

Responsibilities

• Handles telephone communication with patients, insurance companies, and other BMG clinic or BMG Foundation personnel.
• Bills, collects, and submits all insurance and TPA claims according to payer guidelines and established procedures and workflows.
• Reviews and/or processes all credit balances from supplied reports.
• Works all insurance denials, via paper and/or electronic in work queues.
• Monitors and processes all assigned electronic and/or paper claim status (e.g., claim edit and no-response work queues).
• Completes assigned goals.

Requirements

• Minimum required experience in the healthcare setting or educational coursework.
• Preferred/desired: one or more years of government and/or commercial billing and collections in a physician or hospital setting.
• Minimum required: high school diploma or GED.
• Preferred/desired: certification in medical billing or coursework; associate’s degree in Business, Finance, or related field.
• Minimum required: basic computer and keyboarding skills.
• Preferred/desired: MS Office and advanced phone system experience.
• Knowledge of insurance billing and collections guidelines, including payer systems such as FFS.
• Experience with Epic.
• Effective verbal and written communication skills.
• Effective customer service skills.