Billing Specialist

Georgia Spine & Orthopaedics•Roswell, GA

10d

About The Position

Georgia Spine & Orthopaedics is a comprehensive spine and orthopedics care provider in Georgia, with locations in Atlanta, Columbus, Gwinnett, Marietta, Tucker, Stockbridge, Roswell, and the Surgery Center of Roswell. The organization offers cutting-edge treatment with a conservative approach and describes its team as friendly, ambitious professionals focused on exceptional patient care and a positive workplace. The Billing Specialist for Workers' Compensation helps optimize revenue recognition across the organization. Under the direction and supervision of the Billing Manager, the specialist works with the Workers' Compensation Coordinator, Intake/Front Office, and Care Coordinators to check Workers' Compensation data for completeness and accuracy. The specialist flags trends in pended or denied claims and other reimbursement issues, reviews revenue-cycle data to ensure charges are billed correctly and promptly, and challenges inaccurate payments or payment denials.

Requirements

Demonstrated understanding of healthcare billing specific to Workers' Compensation.
Familiarity with ICD-10 and CPT coding and Workers' Compensation fee schedules.
Ability to understand Workers' Compensation rules, regulations, and forms, including pre-certification, prior authorization, and requests to change or add a provider of care.
Ability to review charge, demographic, and financial data for completeness and accuracy.
Demonstrated ability to post charges, payments, and write-offs.
Ability to collaborate with Workers' Compensation case managers, attorneys, insurance adjusters, and employer groups to support client satisfaction and revenue capture.
Ability to review and challenge payment reductions or denials.
Collaboration, teamwork, and problem-solving skills.
Written and verbal communication and listening skills.
Ability to provide excellent customer service.
High level of integrity and trustworthiness in handling confidential information.
Develop skills and proficiency under the office manager's direction to provide constructive feedback to staff and take corrective action when necessary.
Develop skills to hold staff accountable to expectations.

Responsibilities

Ensure patient and payment information is accurate, complete, and promptly entered into the organization's software systems.
Enter charge data daily.
Notify the appropriate team about missing or incomplete data that needs correction.
File invoices or claims as directed by the Billing Manager.
Monitor invoices and claims for timely payment or notice of denial.
Enter payments.
Enter write-offs according to company policy for each payer.
Challenge payments that do not comply with the company's agreement or contract.
Serve as a point of reference for coding, billing, pricing, and payment issues.
Cross-train to cover appropriate roles during staffing shortages.
Prepare daily, weekly, and monthly reports as requested by the leadership team.
Help coordinate the Central Business Office Team and its work with other areas of the company.
Assist medical providers with issues and projects as needed.
Help maintain a positive work environment.
Answer incoming office calls regarding revenue-cycle issues as required.
Perform other duties as requested.
Alert the Billing Manager to trends in Workers' Compensation claims that are pended or denied and to other reimbursement issues.
Review Workers' Compensation revenue-cycle data to ensure charges are billed correctly and on time.