Billing Specialist (GMG)

Genesis Healthcare System

89d•Onsite

About The Position

The Billing Specialist (GMG) bills accurate information to government and commercial payers in accordance with established guidelines and government regulations. The role coordinates GMG billing activities, including processing government payer bills, coordinating third-party billing, and working with other departments, payers, attorneys, patients, and others to ensure claims contain correct information. The specialist addresses rejections, denials, pending and problem claims, and electronic claim or reimbursement issues to support timely and accurate reimbursement. The role also responds to patient billing inquiries in a responsible, professional, and caring manner. The position supports accurate charge entry and coding, posts patient and insurance receipts, reconciles banking and office posting records, and coordinates with coding, credentialing, accounting, practice managers, vendors, and information systems. It also performs verification, pre-certification, and referrals for scheduled surgeries and assists with collections and payment arrangements. Employees are expected to uphold Genesis’s Mission and values of Compassion, Excellence, Integrity, Team, and Innovation; keep patients at the center of their work; protect dignity, privacy, and confidential information; communicate effectively; and contribute to a safe, clean, and quiet workplace. The position is performed in an office environment that can be busy, stressful, and frequently interruptive. Regular duties involve standing, walking, talking, hearing, and using hands and arms; the employee regularly lifts or moves up to 10 pounds and occasionally up to 25 pounds.

Requirements

High school graduate or equivalent.
At least 2 years of experience with PCs/computers.
Knowledge of medical terminology.
Experience using Excel and Word or equivalent applications.
Effective time-management and organizational skills.
Attention to detail, strong communication skills, and effective listening.
Ability to concentrate with frequent interruptions.
Understanding of reimbursement systems, including ICD and CPT.
Specific knowledge of coding applications.

Responsibilities

Bill accurate information to government and commercial payers according to established guidelines and regulations.
Work with payers to resolve problems and support correct, timely reimbursement.
Work rejections, denials, and work lists promptly to prevent write-offs.
Coordinate with coding and credentialing departments to identify and correct denial patterns and support optimum reimbursement.
Reconcile monthly banking logs with Accounting.
Reconcile daily office posting to Epic and share information with appropriate practice managers.
Respond to patient inquiries and concerns professionally and compassionately.
Plan and coordinate third-party billing activities.
Ensure compliance with Medicare and other insurance carrier documentation guidelines.
File medical claims and follow up on pending and problem claims in a timely manner.
Communicate with patients and insurance companies about insurance issues as needed.
Address electronic claim submissions and reimbursement issues with vendors and/or information systems.
Enter charges and verify proper ICD and CPT codes.
Post personal and insurance receipts.
Perform verification, pre-certification, and referrals for scheduled surgeries.
Assist as collection coordinator, answer billing questions, and establish payment arrangements.
Maintain patient dignity and privacy and handle confidential or sensitive information appropriately.
Communicate effectively, respond to requests in a timely manner, and contribute to a safe, clean, and quiet environment.