Billing Specialist

Riverview Health • Noblesville, IN

10d

About The Position

The Billing Specialist is responsible for preparing and submitting claims to assigned insurance companies. This role involves analyzing and correcting claims edits related to billing, charging, and registration errors to ensure timely and accurate claim submission. The specialist will also review charges, verify the appropriate use of modifiers, CPT codes, and ICD-10 codes, and research payer-specific billing and reimbursement rules. Resolving clearinghouse rejections and errors, working within the Epic EMR for claim corrections, and monitoring claim edit work queues are key aspects of this position. Proactive communication of issues is also expected.

Requirements

• High school diploma or GED
• Minimum: One (1) year of experience working with insurance balances in a business office or similar role.

Nice To Haves

• Two (2) years of billing experience working in Epic EMR

Responsibilities

• Prepare and submit claims to assigned insurance companies.
• Analyze, correct, and resolve claims edits related to billing, charging, and registration errors promptly and accurately to ensure clean claims are submitted in a timely manner.
• Review charges and verify appropriate usage of modifiers, CPT codes and ICD-10 codes prior to billing.
• Research, as necessary, any payer-specific billing and reimbursement rules, including but not limited to Correct Coding Initiative (CCI) edits.
• Resolve clearinghouse rejections and errors.
• Works in Epic EMR to make all claims corrections and resubmits claims when appropriate.
• Monitors claim edit work queues to ensure claims are resolved and submitted within 24 hours.
• Proactively communicates problems or issues in a timely manner for continuous workflow.
• Other duties as assigned.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED