Specialist-Billing

Job Summary

Responsible for the daily completion of both 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.

Experience

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.

Education

Minimum Required: High School Diploma or GED.

Preferred/Desired: Certification in medical billing or course work. Associates degree in Business, Finance, or related field.

Training

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.