Billing Specialist 1 | Part-time

Phelps Health

7d•Onsite

About The Position

The Billing Specialist I is responsible for collecting and entering claims, posting insurance, submitting claims, and answering patient inquiries on accounts. This role requires attention to detail in ensuring claim information is complete and accurate, and involves following up with insurance companies on unpaid or rejected claims. The specialist will also prepare appeal letters, handle patient collections, and verify benefits eligibility. The position operates within standard office conditions and requires adherence to HIPAA guidelines.

Requirements

High School Diploma or GED required.
Ability to receive and express detailed information through oral communications.
Visual acuity.
Ability to read and understand written directions.
Normal mental concentration with repetitive operations for a long period of time.
Ability to stand, walk, sit, and reach.
Occasionally lifts and transports items weighing up to ten (10) pounds.

Nice To Haves

Medical billing experience highly preferred.
Experience in billing software and electronic data submission preferred.

Responsibilities

Collects and enters information necessary for insurance claims, including patient, insurance, and insurance ID details.
Ensures claim information is complete and accurate.
Submits insurance claims to clearinghouses or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
Answers patient questions regarding patient-responsible portions, copays, deductibles, write-offs, and explains coverage limitations.
Follows up with insurance companies on unpaid or rejected claims, resolves issues, and resubmits claims.
Prepares appeal letters to insurance carriers when in disagreement with claim denials, collecting necessary information to accompany the letter.
Follows HIPAA guidelines in handling patient information.
May perform soft collections for patient past-due accounts, including contacting and notifying patients via phone or mail.
Understands managed care authorizations and limits to coverage.
Verifies patient benefits eligibility and coverage as needed.
Prepares and submits secondary claims upon processing by the primary insurer.