Billing Specialist

The Billing Specialist position manages and executes all aspects of Third-Party Payer billing and financial tracking.

Essential Functions :

Prepares and submits clean claims to Third Party Payers keeping within the expectations of the billing cycle to remain 7-10 days. Maintains information on billing procedures by client and by payer. Researches and resolves client billing issues with Third Party Payers. Performs various collection actions including review of claim denials to determine if there is a billing error that must be resolved or working with co-workers to determine the necessary steps to obtain claim payment. Follows all insurance policy and regulations. Performs daily follow-up of claims, including resolution of any billing errors. Performs daily task assignments to work various requests from multiple departments. Processes rejections and denials to determine if the claim needs to be corrected and if applicable taking the action to submit a corrected claim. Communicate with clinical staff when errors are identified that will result in billing errors and/or denials. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. Excellent oral, written and interpersonal communications skills. Consistent and regular attendance is a requirement of the position.

Non-Essential Functions/Other Duties :

Performs any other tasks assigned by management.

Supervisory Responsibility :

Not applicable.

Travel Required :

Minimal.

Physical Demands :

This is largely a sedentary role, with frequent sitting and computer keyboarding (10-key) required. Some lifting (up to 35 pounds), stooping and bending are required.

Qualifications :

Education:

High school diploma or equivalent. Coursework and/or experience in medical and/or health insurance billing, medical records management.

Experience:

At least two years of previous medical insurance, billing, or claims processing related experience. Experience and strong knowledge of insurance procedures, reimbursement, contracts, and insurance appeal are preferred. CPT and ICD-10 certification a plus.

Skills and Competencies:

Strong keyboarding and computer skills including MS Office (Word and Excel) experience at an intermediate level. 10-key data entry proficiency. Knowledge of basic medical coding and third-party operating procedures and practices, as well as knowledge of financial concepts. Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc. Knowledge of HIPPA privacy and security rules and regulations. Excellent interpersonal skills, with the ability to communicate effectively with others. Strong organizational skills, with the ability to multi-task and meet deadlines. Demonstrates initiative, with the ability to manage self and workload. Strong analytical and problem-solving abilities. Good mathematical aptitude. Exemplary customer service focus, for both internal and external clients. Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere. Displays professionalism and represents organization in a professional manner. Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.