Billing Specialist Jobs

About The Position

Requirements

• High school diploma for Billing Specialist I and II.
• For Level I: coursework in medical or dental billing, or at least one year of medical/dental billing experience that includes processing and following through on EOB and ERA files, or a combination of coursework and experience.
• For Level II: an associate degree in medical or dental billing or at least two years of medical/dental billing experience (three years desired), including EOB/ERA processing, knowledge of CPT, ICD-10, LCDs, NCDs and modifier guidelines, rejected and corrected claims, payer guidelines, appeals, timely filing limits, and Medicaid and Medicare billing, or a combination of coursework and experience.
• For Level III: an associate degree and/or billing certification (CPC, RHIT, or RCC), and at least three years of medical/dental billing experience (five years desired), including EOB/ERA processing, CPT, ICD-10, LCDs, NCDs and modifier guidelines, rejected and corrected claims, payer guidelines, appeals, timely filing limits, and Medicaid and Medicare billing.
• For Level II and III, knowledge of CPT, ICD-10, LCDs, NCDs, modifier use and guidelines, rejected claims, payer guidelines, corrected claims, appeals, and timely filing limits; Medicaid and Medicare billing experience is required.
• Strong data-entry skills and ability to accurately enter high volumes of information.
• Adept math skills and ability to perform reconciliation functions.
• Organized and detail-oriented, with good computer skills and proficiency in Outlook, Word, and Excel.
• Proficient 10-key skills.
• Strict adherence to HIPAA guidelines and ability to work rejections independently to resolve issues and obtain timely claim payments.
• Ability to multitask, maintain productivity and accuracy, work under pressure, and understand the collections process.
• Trainable, able to follow specific instructions, communicate effectively with staff, patients, and management, work with limited supervision, and keep current with job duties.
• Senior-level staff must be able to work without supervision, take on additional responsibilities, assist the Director as needed, and treat everyone with respect.
• Ability to sit, stand, and/or walk for an entire workday and occasionally lift, carry, push, pull, and/or twist while holding up to 25 pounds.
• Extensive local travel between sites and occasional seminar travel.

Nice To Haves

• Bilingual English/Spanish skills.
• Experience in a family or dental practice.
• For Level II, three years of medical/dental billing experience is desired.
• For Level III, five years of medical/dental billing experience is desired.

Responsibilities

• Review, batch, and transmit or print claims and statements in a timely manner.
• Work rejected files, claims, and statements at submission to confirm they were received by the clearinghouse and sent to insurers or patients.
• Maintain assigned accounts receivable, targeting a days-in-AR ratio below 90 while maintaining the standard gross collection ratio.
• Work proactively with insurance companies and patients to resolve payment issues, communicate backlogged accounts receivable to the Manager, and work credit balances within 60 days.
• Process and post credit card, EOB, and ERA payment files accurately and promptly, balancing deposits to postings for each batch.
• Coordinate with billing staff to ensure payments, deductibles, and copays are posted monthly.
• Enter CAS and rejection codes, dates, and coordination-of-benefits information when posting; approve secondary claims for transmission the day after posting.
• Research and resolve rejected claims, including contacting insurers, correcting claims according to payer requirements, and following through on resubmission.
• Communicate claim issues to the Manager and staff.
• Answer calls from patients and insurance carriers and provide accurate information to resolve claim-related issues and collect payment for services.
• Initiate payment plans, review patient accounts, pursue payment, and resolve outstanding visits and credit balances.
• Advise patients of past-due balances, seek payment or budget plans, and coordinate applicable collection-agency balances.
• Handle incoming mail as instructed by the Manager and assist other assigned positions, including preparing applications and related paperwork.
• At senior levels, mentor and train staff, review accounts receivable and rejection trends, research causes and solutions, support management with departmental policies and duties, and work independently.
• At Level III, provide support to specified departments as assigned and coordinate work accurately and promptly with staff.

Benefits

• Mileage and travel reimbursement according to the GLBHC travel policy.