Billing Specialist

Holding Hands OpCo•Burbank, CA

10h•Onsite

About The Position

The Billing Specialist is responsible for the accurate and timely processing of patient claims to ensure proper reimbursement. This role works closely within the Billing and Admissions department and understands the direct impact that billing accuracy and efficiency have on the organization’s revenue cycle and overall financial performance.

Requirements

Completion of college level coursework with a minimum of three to five years of relevant work experience, or an equivalent combination of education, training, and experience required.
Demonstrated experience in commercial and Medicaid billing or coding within a healthcare setting required.
Working knowledge of medical terminology required.
Strong ability to multitask, prioritize responsibilities, and manage competing deadlines.
Effective communication, interpersonal, and computer skills required.
Ability to establish and maintain professional working relationships with staff and patients.
Highly detail oriented with strong accuracy in reviewing charge batch submissions, analyzing and correcting coding denials, and preparing and presenting reports or analyses.
Maintain current knowledge of industry regulations, payer requirements, and billing guidelines.
Proficient in Microsoft Office applications required.

Responsibilities

Comply with all company policies, procedures, and regulatory requirements.
Meet assigned productivity standards, deadlines, and performance goals.
Maintain strict adherence to all legal and ethical billing practices, including federal and state regulations.
Ensure the accurate and timely collection, preparation, verification, and submission of billing information within the EMR system.
Review billing, collections, and denial reports regularly and recommend corrective actions to resolve and prevent claim denials.
Serve as a liaison between payors, patients, and internal departments to address inquiries, provide documentation, and resolve billing issues.
Review daily charge entries to confirm accurate CPT, ICD-10, and all required billing codes are complete and compliant.
Compare coding against clinical documentation and collaborate with providers to clarify discrepancies, correct errors, and prepare appeals and reconsideration requests as needed.
Research and appeal complex denials by reviewing payer policies, coding guidelines, contracts, and medical records, consulting subject matter experts when appropriate.
Audit clinical documentation to ensure appropriate charge capture, maintain compliance, and reduce risk of denials.
Identify denial trends and provide education to practice staff to improve documentation accuracy, authorization review, and overall billing performance.