Billing Specialist Jobs

About The Position

Requirements

• At least 2 years of medical collections or billing experience.
• Intermediate knowledge of ICD-10, CPT, HCPCS, and NCCI.
• Intermediate knowledge of third-party billing guidelines.
• Intermediate knowledge of billing claim forms (UB04/1500).
• Intermediate knowledge of payer contracts.
• Working knowledge of Microsoft Word and Excel.
• Intermediate working knowledge of health information systems, such as EMR, claim scrubbers, and patient accounting systems.

Nice To Haves

• Working knowledge of one or more patient accounting systems: EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.
• Working knowledge of the DDE Medicare claim system.
• Knowledge of government rules and regulations.

Responsibilities

• Use hospital and physician systems to verify patient, billing, and claim information for accuracy.
• Perform compliant primary, secondary, tertiary, and rebill billing, including electronic, paper, and portal submissions to payers.
• Edit claims to meet billing compliance guidelines for electronic and hardcopy submission.
• Respond to emails and telephone messages in a timely manner.
• Communicate payer, system, and escalated account issues to management.
• Attend meetings, training seminars, and in-services as requested to develop job knowledge.
• Adhere to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards.
• Accept ownership of new and different requests and seek opportunities to add value to job accomplishments.
• Update patient demographics and insurance information in appropriate systems.
• Monitor claims for missing information, authorization, and control numbers (ICN/DCN).
• Follow guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems.
• Obtain medical documentation required or requested by third-party insurance carriers.
• Maintain patient confidentiality in accordance with insurance collection guidelines and corporate policy and procedure.
• Use provider billing manuals to obtain billing guidelines and requirements.
• Verify imports and escalate import/export files.
• Perform special handling billing, including interim bills, overlap review, and redistribution of money for correct claim creation.
• Research and resolve billing rejections.