Billing Specialist II

Great Lakes Bay Health CentersSaginaw, MI
10d

About The Position

The Billing Specialist II (Senior Level) is expected to accurately process and post payments and rejections and find immediate resolution to billing issues in the department. Acting as a Mentor to the Billing Specialist I and being a team player. The Senior Level will monitor trends and communicate with department on any issues or updates that need to be addressed immediately while ensuring all AR is kept current working with no supervision knowing when and how to handle various situations and the importance of completing them.

Requirements

  • High School Diploma.
  • Associates degree in Medical or Dental Billing OR Minimum of two (2) years’ required and 3 years’ desired experience in Medical/Dental Billing, including: 1) processing and following through on Explanation of Benefits (EOB) and ERA files; 2) experience and understanding of CPT, ICD 10, LCD's, NCD's and modifier use/guidelines; 3) experience working rejected and corrected claims, knowledge of payor guidelines and minimal resubmissions, handling appeals and understanding timely filing limits. Medicaid and Medicare billing experience. OR a combination of coursework and experience.
  • Knowledge of CPT, ICD 10, LCD's, NCD's and modifier use/guidelines. In depth knowledge of rejected claims and payor guidelines which includes minimal resubmissions, corrected claim submissions, appeals and understanding timely filing limits. Medicaid and Medicare billing experience is required.
  • Strong data entry skills; ability to input a high-volume information accurately. Adept math skills with strong ability to perform reconciliation functions. Organized and detail oriented. Must have good computer skills, proficiency with Outlook, Word, and Excel. Proficient 10 key skills. Bilingual (English/Spanish) preferred. Demonstrates strict adherence to HIPAA guidelines. Expertise in working rejections to resolve issues and obtain timely payment of claims independently. Ability to multi-task and provide a high level of productivity while maintaining accuracy. Must be able to work under pressure. Understand collection process. Desire to learn and master new things, seek help when needed and willingly assist others in time of need.
  • Trainable and able to follow specific instructions. Ability to communicate effectively with other staff, patients, and management. Able to work with limited supervision and keep current with all job duties. Senior Level staff must show that they have the ability to move to the next level assisting Director in duties as needed and can work with no supervision and are willing and able to take on more responsibilities in the department.
  • Must be able to sit, stand, and or walk for an entire workday. Must be able to lift, carry, push, pull, and or twist while holding up to 25 lbs. occasionally.
  • Full-time.
  • Flexible and varied.
  • Extensive local travel between sites. Occasional seminar travel. Mileage and travel reimbursement according to GLBHC travel policy.

Nice To Haves

  • Experience in Family or Dental Practice.

Responsibilities

  • Ensure all claims are submitted for prompt payment.
  • Maintain AR.
  • Process Payments and Rejections.
  • Responsible for resolving rejected claim issues to ensure payment of claim.
  • Assists department maintaining patient accounts and providing customer service.

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What This Job Offers

Job Type

Full-time

Career Level

Mid Level

Education Level

Associate degree

Number of Employees

101-250 employees

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