Charges and Claims Specialist (Chesapeake Specialty Care)

University of Maryland Faculty Physicians•Baltimore, MD

About The Position

The Charges and Claims Specialist is responsible for managing the initial creation of claims and their submission to Insurance, or designation of patient responsibility. This role involves the submission of claims, handling patient and insurance communications, and performing any additional tasks needed to ensure accurate and timely claim processing.

Requirements

High school diploma or equivalent
Minimum 2-3 years of experience in medical billing
Experience with practice management systems and EHR platforms
Familiarity with medical terminology and CPT/ICD-10 codes
Familiarity with Microsoft applications, including, but not limited to Word and Excel.
Strong knowledge of medical insurance plans (commercial, Medicare, Medicaid, Tricare)
Knowledge of basic medical coding and third-party operation procedures and practices.
Excellent communication and customer service skills
Strong written and verbal communication skills including the ability to confidently speak to patients
Excellent organizational skills to manage multiple tasks throughout the day.
Ability to operate a multi-line telephone system and answer a telephone in a pleasant and helpful manner.
Demonstrate the ability to work as a team player in a very cohesive medical practice.
Ability to communicate and work well with co-workers.
Open and honest communication.
Ability to effectively communicate orally and in writing with internal and external business professionals.
Must be responsible, reliable, and able to carry out job functions.

Responsibilities

Review all claims that have been created by Providers billing.
Communicate any billing errors to providers for clarification prior to submission to insurance or billing to patients.
Communicate any Demographic errors with appropriate office staff prior to submission to insurance or billing to patients.
Prepare and submit clean insurance claims daily for all services provided electronically and manually.
Submit electronic Claims to Insurance Daily.
Work any claims electronically rejected by the clearinghouse or the insurance company.