Billing Specialist

Overview

Responsible for the billing of claims and resolving claim issues for commercial and government insurances by following the approved processes, policies and procedures set by the Regional Billing Organization Responsibilities

• Prepare and correct claims to cleanly pass from the EMR to clearinghouse.
• Perform posting charges and completion of claims to payers in a timely fashion.
• Resolve patient accounts through the correction of billing edits and clearinghouse rejections.
• Navigate portals to send claims for adjudication.
• Prepare invoices to send to third party payers.
• Prepare enrollments to send claims through the clearinghouse.
• Analyze and identify trends to reduce the number of claim denials.
• Communicate clearly and in a positive manner with assigned staff.
• Provide excellent customer service to team members and patients.
• Meets important deadlines consistently especially during end-of-month/EOM closings.
• Supports the team in reaching or exceeding target goals for productivity.
• Participates in continuing educational activities relative to assigned duties and responsibilities.

Qualifications

• High school diploma or GED required.
• Minimum 5 years of medical billing experience
• Computer proficiency and experience in Windows-based technologies
• Ability to be discreet and protect patient PHI.
• Prior work experience in a medical office setting preferred.
• Excellent problem-solving skills, attention to detail, management of multiple tasks and the ability to do so independently.
• Ability to handle difficult situations with a positive attitude.
• Good interpersonal, oral, and written communication skills.
• Must be able to work as part of a team with peers and leadership within the organization
• Prepare and correct claims to cleanly pass from the EMR to clearinghouse.
• Perform posting charges and completion of claims to payers in a timely fashion.
• Resolve patient accounts through the correction of billing edits and clearinghouse rejections.
• Navigate portals to send claims for adjudication.
• Prepare invoices to send to third party payers.
• Prepare enrollments to send claims through the clearinghouse.
• Analyze and identify trends to reduce the number of claim denials.
• Communicate clearly and in a positive manner with assigned staff.
• Provide excellent customer service to team members and patients.
• Meets important deadlines consistently especially during end-of-month/EOM closings.
• Supports the team in reaching or exceeding target goals for productivity.
• Participates in continuing educational activities relative to assigned duties and responsibilities.
• High school diploma or GED required.
• Minimum 5 years of medical billing experience
• Computer proficiency and experience in Windows-based technologies
• Ability to be discreet and protect patient PHI.
• Prior work experience in a medical office setting preferred.
• Excellent problem-solving skills, attention to detail, management of multiple tasks and the ability to do so independently.
• Ability to handle difficult situations with a positive attitude.
• Good interpersonal, oral, and written communication skills.
• Must be able to work as part of a team with peers and leadership within the organization