Billing Specialist Jobs

About The Position

Requirements

• High School diploma or equivalent required.
• Minimum of one year billing experience.
• Pass a PA Criminal Background Check
• Obtain PA Child Abuse and FBI Fingerprinting Clearances
• Pass Drug Screen
• 2-Step TB Test

Nice To Haves

• Understanding of healthcare billing practices
• Familiarity with commercial insurance providers, including prior authorizations and claim submissions.
• Knowledge of the full billing cycle, including charge entry, claims processing, payment posting, and collections.
• Knowledge of basic accounting principles.
• Understanding of patient privacy laws and healthcare compliance standards.

Responsibilities

• Processes, edits, audits and posts service entries into the EHR.
• Generates clean claims, invoices and patient bills for services provided to all patients based on third party payer criteria.
• Monitors and collects outstanding accounts receivable and performs investigation and follow-up on open balances.
• Reviews Explanation of Benefits/Remittance Advices for correct payment, copays, deductibles and denials.
• Tracks, analyzes, and reports monthly to director regarding composition of outstanding accounts receivable, determining collectability and internal and external issues concerning receipt of payment.
• Participates in the monthly closings and provides data and analysis for all payers.
• Communicates with the utilization review department regarding authorizations issues and inquiries.
• Completes necessary processes for adjustments, write-offs, charity care and refunds.
• Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies for problem resolution with funding sources or patient services.
• Maintains interdepartmental reports for patient accounts and collections.
• Communicate with third party Collection Management Company and patients concerning self-pay balances or billing issues.
• Assists in the FY audits.
• Communicates with the Medical Records department for applicable data required for patient appeals and denials.
• Works on special projects as needed.
• Attends mandatory Gateway training and in-services.