Billing Specialist
About The Position
Maintains productivity and accuracy metrics per department expectations. Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers. Reviews insurance rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding rejections. Correct and identify billing errors and resubmit claims to insurance carriers. Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans. Assist in identifies and communicating trends and/or potential issues to management team. Payer website user access maintenance. Responsible for system maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments. Responsible for EDI, ERA and EFT enrollments for all payers.
Requirements
- High school diploma or GED
- Minimum two to three years of experience in medical billing.
- Prior experience working claim errors in a claims management system.
- Demonstrated knowledge of revenue cycle applications.
- Advanced computer knowledge, including Window based programs.
- Knowledge of ICD-10, HCPS, and CPT codes, medical terminology, and billing practices.
Nice To Haves
- Knowledge of ERA/EFT enrollment as well as ANSI formatting.
- Prior experience configuring revenue cycle vendor-supplied software.
Responsibilities
- Maintain productivity and accuracy metrics per department expectations.
- Work claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
- Review insurance rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding rejections.
- Correct and identify billing errors and resubmit claims to insurance carriers.
- Verify patient demographic information and insurance eligibility including coordination of benefits; update and confirm as necessary to allow processing of claims to insurance plans.
- Assist in identifying and communicating trends and/or potential issues to management team.
- Payer website user access maintenance.
- System maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments.
- EDI, ERA and EFT enrollments for all payers.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
High school or GED
