Billing Specialist

ABHS•Marlton, NJ

About The Position

The Billing Specialist is responsible for providing support to the Revenue Cycle Department. This position manages a very high volume of claims and must work quickly and efficiently to manage the consistent flow of work.

Requirements

High School Diploma or equivalent
Billing and Coding Certification from one of the following national certification exams:
American Medical Billing Association - Certified Medical Reimbursement Specialist (CRMS) Board Exam
AAPC - Certified Professional Coder's (CPC®,) Certified Outpatient Coder (or CPC-HCOC™) [formerly CPC-H®,] Certified Inpatient Coder (CIC™,) or Certified Professional Medical Auditor (CPMA®) Board Exam
American Health Information Management Association - Certified Coding Associate (CCA®,) Certified Coding Specialist (CCS®,) or Certified Coding Specialist Physician-Based (CCS or CCS-P®) Board Exam - The CCS & CCS-P credentials require experience in addition to the education
Billing and Coding: Minimum of 1 year
CPT and ICD coding
Computer literate: Microsoft Office (Excel, Word, and PowerPoint) required.
Enthusiastic self-starter operating with sustained energy and showing great initiative.
Comfort working with a diverse base of support, including members, employers, providers, colleagues, community leaders, volunteers, non-profit organizations, vendors, etc.
Excellent interpersonal and communication skills, including ability to read, write, spell in English legibly and without excessive grammatical or communication errors.
Talk and hear both by person and by telephone; ability to speak clearly and effectively using proper grammar before patients, employees and business partners, among others.
Excellent organizational skills.
Accepts constructive criticism well in an open and non-defensive manner.
Ability to manage conflicting priorities.
Ability to maintain a positive work ethic and a congenial attitude in the face of a high-pressure environment.
Ability to function independently and with flexibility.
Ability to work under pressure, handle multiple tasks and interruptions.
Occasional lifting of moderately heavy office supplies; ability to lift supplies for community events, trade shows, conferences, and other marketing opportunities applicable to the organization; ability to lift, push or pull up to 25lbs.
Ability to sit, stand, or walk for extended periods of time.
Must have strong computer skills to meet Microsoft Office and Electronic Health Record software requirements.

Responsibilities

Generates insurance claims and collects outstanding insurance balances.
Submits appeals and reconsiderations to insurance companies.
Makes follow-up calls to the insurance companies on accounts with outstanding balances.
Maintains standards to ensure systematic, consistent, and timely collection follow-up.
If claims are denied by the third-party payer, the medical billing specialist must investigate the claim, verify its information, and update the database.
Ensure medical records needed for billing purposes are in client’s charts and/or submitted.
Completes all payer rejections in a timely manner in accordance with department standards.
Identifies, separates, and mails claims that require paper submissions for timely submission.
Monitors provider enrollments to assure that claims process correctly to ensure timely reimbursements.
Reviews, researches, and amends correspondence/explanation of benefits and makes appropriate adjustments to accounts.
Identifies and communicates possible system and reimbursement problems to facilitate an efficient and accurate review of the payers.
Meets billing compliance standards.
Contact insurance carriers to have claims reprocessed in accordance with contracts and plan benefits.
Protects Facility value by keeping collection information confidential.
Update job knowledge by participating in continuing education opportunities.
Review billing reports identify areas that need attention.
Provide supervisor with follow up from billing reports.
Bi-weekly supervision.
Assists and covers other staff when necessary to maintain high productivity and efficiency in the department.
As the company continues to grow, additional responsibilities that are essential for the department to be successful will be assigned accordingly.
Demonstrates ability to function effectively as a part of team.
Uses outstanding oral and written communication with employees at all levels of the business for support and sharing of information.
Take constructive feedback and prevent discourse among our peers.
Critically thinking should be the solution when problems arise.
Having the ability to accepts constructive criticism well in an open and non-defensive manner.
Wear business casual attire (please see dress code policy).