Billing Specialist

Caravel Autism HealthGreen Bay, WI
7hHybrid

About The Position

The Billing Specialist position manages and executes all aspects of Third-Party Payer billing and financial tracking.

Requirements

  • High school diploma or equivalent.
  • Coursework and/or experience in medical and/or health insurance billing, medical records management.
  • At least two years of previous medical insurance, billing, or claims processing related experience.
  • Strong keyboarding and computer skills including MS Office (Word and Excel) experience at an intermediate level.  10-key data entry proficiency.
  • Knowledge of basic medical coding and third-party operating procedures and practices, as well as knowledge of financial concepts.
  • Experience working with basic office machinery and equipment, including computers, copiers, fax machines, multi-line phone systems, etc.
  • Knowledge of HIPPA privacy and security rules and regulations.
  • Excellent interpersonal skills, with the ability to communicate effectively with others.
  • Strong organizational skills, with the ability to multi-task and meet deadlines.
  • Demonstrates initiative, with the ability to manage self and workload.
  • Strong analytical and problem-solving abilities.  Good mathematical aptitude.
  • Exemplary customer service focus, for both internal and external clients.
  • Able to work both independently and be self-directed, as well as being able to perform in a team atmosphere.  
  • Displays professionalism and represents organization in a professional manner.
  • Ability to abide by ethical guidelines and policies, including strict adherence to confidentiality and HIPPA guidelines.
  • Must be 18 years old or older.

Nice To Haves

  • Experience and strong knowledge of insurance procedures, reimbursement, contracts, and insurance appeal are preferred. CPT and ICD-10 certification a plus.

Responsibilities

  • Prepares and submits clean claims to Third Party Payers keeping within the expectations of the billing cycle to remain 7-10 days.
  • Maintains information on billing procedures by client and by payer.
  • Researches and resolves client billing issues with Third Party Payers.
  • Performs various collection actions including review of claim denials to determine if there is a billing error that must be resolved or working with co-workers to determine the necessary steps to obtain claim payment.
  • Follows all insurance policy and regulations.
  • Performs daily follow-up of claims, including resolution of any billing errors.
  • Performs daily task assignments to work various requests from multiple departments.
  • Processes rejections and denials to determine if the claim needs to be corrected and if applicable taking the action to submit a corrected claim.
  • Communicate with clinical staff when errors are identified that will result in billing errors and/or denials.
  • Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
  • Excellent oral, written and interpersonal communications skills.
  • Consistent and regular attendance is a requirement of the position.
  • Performs any other tasks assigned by management.
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