BILLING SPECIALIST
POSITION SUMMARY:
The Billing Specialist is responsible for handling all aspects of claims processing beginning with a bill ready file and following the claim through the full adjudication process.  In addition to regularly assigned claims, the need may arise for various projects that focus on increasing claim reimbursement or resolving outstanding balances and the Billing Specialist will play an important role in such projects.   We currently handle the billing for free-standing emergency rooms, urgent care centers and outpatient radiology. 

ESSENTIAL FUNCTIONS:

• Reviewing patient bills for accuracy, completeness, and obtaining any missing information
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing
• Respond timely to any request for additional information
• Following up on unpaid claims within standard billing cycle timeframe
• Checking each insurance payment for accuracy and compliance with possible contract or negotiation discounts
• Calling insurance companies regarding any discrepancy in payments
• Identifying and billing any secondary or tertiary insurances
• Reviewing accounts for insurance or patient follow-up
• Research and appeal denied claims
• Answering all patient or insurance telephone inquiries pertaining to assigned accounts
• Setting up patient payment plans and work collection accounts

• Prior medical billing experience preferred (1 – 3 years)
• Preferred experience working and negotiating out of network claims
• Familiar with current state and Federal NSA regulations and processes preferred
• Knowledge of Medicare, commercial insurances and government insurances
• Ability to work independently with minimal supervision is required

• This position is solely computer usage which means employees will be sitting and typing throughout their scheduled shift