Insurance Billing Specialist

Burn and Reconstructive Centers of America LLC•Augusta, GA

About The Position

The Insurance Billing Specialist position is responsible for managing outstanding insurance accounts receivable to optimize cash flow and secure timely reimbursement. This role focuses heavily on tracking denials, submitting complex appeals, to proactively reduce days in AR. The ideal candidate possesses deep expertise in physician billing, commercial and government payer guidelines, and root-cause analysis. Burn and Reconstructive Centers of America (BRCA) is committed to following its mission: Healing Patients. Healing Families. Healing Lives. BRCA is the nation's most extensive burn system, providing quality burn, hand, wound and reconstructive care to patients through new facilities, new partnerships and the latest advancements in care.

Requirements

High school diploma or general education degree (GED)
Two years related experience and/or training (Insurance billing and coding experience from previous medical billing office)
Experience must be combined with Education

Responsibilities

Manage patient account insurance balances.
Denials and insurance follow up management.
Appeals incorrectly paid or denied claims.
Handle insurance inquiries.
Post adjustments and transfer of responsibility to insurance and/or patient.
Issue refunds after auditing accounts.
Negotiates settlements and sets up payment arrangements with insurance carriers and patients.
Works with credentialing department to ensure that all providers are credentialed and communicate and provider enrollment status.
Monthly conference calls and/or site visits with insurance carrier representatives.
Follow up on assigned accounts by a specific payer.
Works with precertification department to obtain authorizations.
Maintain working knowledge of regulations, guidelines, policies, and procedures for all insurance companies that pertain to physician and non-physician practitioners CPT codes.
Keeping claims current to avoid untimely denials for appeals and corrected claims.
Submit secondary claims w/ EOB
Take patient billing calls and assist in any billing questions and/or payments.
Maintain in close contact with insurance reps/adjusters, case managers regarding the issues we have with their perspective insurance company.
Comply with all safety policies, practices and procedures. Report all unsafe activities to supervisor and/or Human Resources.
Participate in proactive team efforts to achieve departmental and company goals.
Perform other duties as assigned.
Provide leadership to others through example and sharing of knowledge/skill.
Participate in education sessions specific to corporate needs or job duties – locally or remotely, as needed.
Provide training to other employees – locally or remotely, as needed.
Maintain confidentiality of sensitive information.
Participate in all mandatory training relating to applicable healthcare laws and regulations, and demonstrate full compliance with those regulations, including without limitation, HIPAA, OSHA, OIG, Federal, State and local laws and regulations.