Billing Specialist

ECU Health Medical Center•Greenville, NC

3d•$18 - $26•Remote

About The Position

The Billing Specialist ensures consistent resolution of pre- and post-billing edits to promote optimal reimbursement. The role generates, reviews, and transmits claims for hospital and physician services to government and non-government payers, and collaborates across Revenue Cycle departments to resolve billing edits and other up-front billing issues completely and efficiently. Attention to detail and effective communication with insurance companies, revenue cycle departments, and clinical areas are critical. This is a full-time, remote role based out of Greenville, North Carolina, with a Monday–Friday day shift. The pay range is $17.66–$25.74 per hour. ECU Health describes itself as a mission-driven, not-for-profit academic health care system with 13,000 team members, nine hospitals, and a physician group of more than 1,100 providers.

Requirements

High school diploma, equivalent, or higher.
Four years of electronic billing and/or billing-editing experience in a hospital and/or physician-office setting.
Working knowledge of HCPCS, CPT-4, ICD-10 coding, and medical terminology.
Familiarity with multiple payer requirements and regulations for claims processing.
Ability to work independently and carry out oral and written instructions.
Ability to apply CPT, HCPCS, and ICD-10 coding guidelines, billing documentation, and documentation standards to daily claims management.
Problem-solving, analytical, organizational, and time-management skills.
Strong communication and customer-service skills, including the ability to resolve end-user issues cooperatively and accurately and build relationships with internal personnel and external contacts.
Attention to detail, accuracy, completeness, and thoroughness in research, data entry, and recordkeeping.
Computer proficiency with Microsoft Word, Excel, Outlook, PowerPoint, and internet applications.
Knowledge of third-party physician billing and demonstrated understanding of automated processes and claims submission.
Ability to accurately manage detailed information.
Proficiency with billing software and Microsoft Office Suite, including Excel and Word.
Understanding of basic medical terminology.
Ability to communicate effectively with internal teams and external clients.
Leadership skills and ability to motivate and develop a team.
Ability to work well under pressure.

Nice To Haves

Epic experience.
Certified Revenue Cycle Associate (CRCA).
Certified Professional Coder—Hospital Services (CPC).
Certified Coding Specialist (CCS).

Responsibilities

Resolve pre-bill and claim-scrubber edits accurately and in compliance with government and commercial payer billing guidelines before releasing claims for submission.
Bill services within departmental timely-filing goals and insurance guidelines.
Review billing-related denials to identify trends and improve clean-claim rates.
Produce daily billing-indicator reports using various reporting tools.
Bill hard-copy claims and attach required supporting documentation.
Retrieve EOBs and medical records as needed, attach them to claims, and mail them.
Contact patients, insurers, and third parties to obtain insurance information or additional billing data.
Perform rebill projects and additional daily reporting.
Understand and comply with rules regarding billing edits.
Maintain working knowledge of UB-04 and CMS-1500 claim forms and their required data elements.
Follow state and federal regulations and system policies concerning compliance, integrity, and ethical billing practices.
Complete appropriate reports and work queues.
Escalate payer issues and report improvement opportunities as appropriate.
Complete special reports or projects assigned by a Supervisor, Manager, or Director.