Billing Specialist (Practice)

ALLERGY PARTNERS•Cary, NC

2d•Onsite

About The Position

This position will be responsible for scrubbing claims for accuracy in billing. This position will be charged with retrieving, approving, batching, and scrubbing claims to avoid errors that would cause the claim to reject or deny.

Requirements

High school diploma, or equivalent, required.
Minimum eighteen months experience in a medical office reimbursement department.
Comfortable using email and interacting with Internet applications.
Working knowledge of MS Excel, MS Word, and understanding of practice management software.
Basic understanding of Explanation of Benefits forms, claim forms and the insurance billing process.
Strong written and verbal communication skills.

Responsibilities

Retrieve claims from the Electronic Medical Records (EMR).
Review EMR documentation where appropriate.
Diagnosis coding for known appropriateness for the visit and for the carrier guidelines.
Ensure charges, diagnosis pointers, modifiers, and NDCs (if necessary) are correct and there are no duplicates.
Ensure that the correct provider, site, insurance, filing type, and referrals/authorizations are selected.
Work exceptions caught by system scrubbing.
Work Front End Rejections.
Communicate with appropriate person(s) with any questions or concerns. This could include - but not limited to - hub personnel, provider, coding team and others within the CBO.
Approve and batch claims.
Periodically check for Unretrieved Charges.
Communicate with others of observed trends.
Recognizing the need for additional scrub rules based on trends.
Ability to work independently and as part of a team with the capability to shift between projects while maintaining productivity and efficiency.
Attends Medicare and other continuing education courses as requested.
Pursue and participate in education to remain current with changes in the Healthcare industry.
Maintain patient confidentiality, comply with HIPAA and compliance guidelines established by the practice to keep information confidential.
Maintains detailed knowledge of practice management and other computer software as it relates to job functions.
Attends all meetings as requested including regular staff meetings.
Completes all assigned AP training (such as CPR, OSHA, HIPAA, Compliance, Information Security, others) within designated timeframes.
Complies with Allergy Partners and respective hub/department policies and reports incidents of policy violations to a Supervisor/Manager/Director, Department of Compliance & Privacy or via the AP EthicsPoint hotline.
Models the AP Code of Conduct and demonstrates a commitment to the AP Compliance Program, standards, and policies.
All other projects and duties as assigned.