Insurance Billing Specialist- In Person

Spartanburg Regional Medical CenterSpartanburg, SC
91d

About The Position

The Insurance Billing Specialist is responsible for a range of billing processes related to managing the ready to bill unbilled revenue. This position is responsible for the timely and accurate billing of all patient accounts to meet and/or exceed our departmental goals for cash collections and AR.

Requirements

  • High School Diploma or equivalency.
  • Must have had at least 4 years electronic billing and/or billing editing experience in a hospital and/or physician office setting.
  • General Knowledge of HCPCS, CPT-4 and ICD9-10 coding and/or medical terminology.
  • Familiar with multiple payer requirements and regulations for claims processing.
  • Solid Microsoft Office skills required.
  • Good communication skills and the ability to courteously interact with multiple departments within SRHS.

Nice To Haves

  • Healthcare related Associates or Bachelor's degree.
  • 5+ years billing experience in a hospital and/or physician billing setting.
  • Experience in billing both technical and professional charges.
  • Experience with DDE.
  • Certified Revenue Cycle Associate (CRCA).
  • Certified Professional Coder- Hospital Services (CPC-H).

Responsibilities

  • Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers.
  • Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical billing practices.
  • Must possess a good working knowledge of the UB04 and CMS 1500 claim forms and the data elements/field data required.
  • Responsible to bill all services within timely filing as defined by departmental goals and insurance guidelines.
  • Must understand and comply with the rules regarding edits.
  • Responsible for all billing related denials to identify trends to improve clean claim rates.
  • Responsible for multiple daily reporting of billing indicators through various reporting tools.
  • Must be able to accurately complete review and resolve all combined billing requirements to ensure compliance.
  • Responsible to work all referrals within a 24/48-hour turnaround time from receipt.
  • Exhibit good professional communication and customer service skills at all times while working with coworkers and employees in multiple departments within the system.
  • Other duties as assigned.
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