Billing Specialist

Reports to:  Controller

Education Requirements:  High School Diploma

Experience/Qualifications:  

• 2-3 years Medical Billing Experience
• Attention to detail and extreme accuracy in filing of documents
• Knowledge of insurance and Medicare billing
• Proficiency in Excel for running reports
• Good communication skills / customer service skills
• Detail Oriented, organized
• Experience with Telcor billing software preferred
• Knowledge of CPT and ICD10 codes required
• Collections experience

Physical Effort:  Listed below are the physical demands of the job according to percentage of time performing the tasks including any applicable weight movements.

Summary of Position:

Responsible for ensuring the completeness and accuracy of billing documents by referring to available information or data provided by the client, physician or other available sources.  Create, review and complete all claims prior to filing.   Understand all phases of billing.   Keep the Manager informed on the status of all accounts receivable and any open issues.

Job Duties/Key Responsibilities:

1. Prepare and submit clean claims to various insurance companies either electronically or by paper in accordance with federal laws, state laws and departmental procedures.   Review edits and rejections stemming from electronic billing submissions and the correction and re-submission of same.   
2. Respond to all patients and insurance company inquires related to billing.
3. Identifies and resolves patient billing complaints.
4. Prepares reviews and sends patient statements.  Generates self-pay bills to patient for the portion of bill not covered by insurance.
5. Processes payments from insurance companies and prepares a daily deposit
6. Accurate filing of patient report / records
7. Evaluates patient’s financial status and establishes payment plan.  Follows and reports status of delinquent accounts.
8. Reviews accounts and makes recommendations to the Controller who determines which accounts are turned over for collection.
9. Performs various collection actions including contacting patients by phone, correcting and resubmitting claims.
10. Initiate refund request for Controller’s approval.
11. Maintains strictest confidentiality; adheres to all HIPAA guidelines / regulations.
12. Maintain up to date expertise and knowledge of healthcare billing laws, rules, regulations and developments necessary for the company to make informed business decision.
13. Perform month end close.   Prepare monthly reports related to tests performed as well as reimbursement. 
14. Monitor payer reimbursement for adherence to contract provisions and fee schedules.
15. Other duties as assigned