Billing Specialist - Guaynabo PR
About The Position
The Billing Specialist will be responsible for creating invoices for managed medical plans, including but not limited to FM Medical Vital, Menonita Vital, Triple S (All LOB), Humana, MMM, MCS, and others. This role also involves creating invoices for secondary medical plans and foundations, handling and using billing programs, and ensuring timely and accurate billing. The specialist will manage the electronic transmission or paper sending of invoices, confirm transmitted invoices, and review/correct rejected invoices. They will also be responsible for meeting productivity and metrics established in monthly work plans, meeting the monthly billing close, and investigating/resolving billing problems, referring them to the Supervisor if necessary. Additionally, the role requires contacting medical offices, patients, and medical plans as needed, updating medical plan circulars, maintaining up-to-date medical plan rate charts, filing sent invoices, and deactivating paid cases. Assisting in the preparation of patient payment agreements, quotes, or proof of receipt is also part of the responsibilities.
Requirements
- High school diploma.
- Medical Billing Certification (preferred) or equivalent to 2 years of billing experience.
- Continuing Education Certificates in the area of billing (preferred).
Responsibilities
- Creation of invoices for managed medical plans (e.g., FM Medical Vital, Menonita Vital, Triple S, Humana, MMM, MCS).
- Creation of invoices for secondary medical plans and foundations.
- Handling and use of billing programs.
- Bill within the required time and in the correct manner.
- Responsible for the electronic transmission or sending of paper invoices and for accepting and confirming transmitted invoices.
- Responsible for reviewing, analyzing, and correcting invoices rejected in transmission.
- Meet the productivity and metrics established in the monthly work plans.
- Meet the monthly billing close.
- Investigate and resolve billing problems and refer them to the Supervisor if necessary.
- Contact medical offices, patients, and medical plans if necessary.
- Update medical plan circulars.
- Have up-to-date medical plan rate charts.
- File sent invoices on paper and deactivate paid cases.
- Assisting the preparation of patient payment agreements, quotes, or proof of receipt.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
