The Billing Specialist is responsible for filing of clean claims to various insurance companies for all Hospital, Provider Based Clinic and Clinic services. They will pursue collection of all claims until payment is made by insurance company. Biller will maintain current billing knowledge and changes of Medicare, Medicaid, and all third party payers.
Prepares and submits clean claims to various insurance companies either electronically or by paper.
Verify all required information necessary to file all insurance claims and insure that they are submitted timely and correctly.
Work with providers or hospital departments to ensure correct charges, diagnosis and procedures are reported to insurance companies.
Follow up on unpaid claims within standard billing cycle timeframe.
Identifies and resolves patient billing complaints.
Check insurance payments for accuracy and compliance with contract or discounts.
Contact insurance companies regarding any discrepancy in payment.
Identify and bill secondary or tertiary insurances.
Handles all mail and correspondence appropriately and timely.
Investigates claims involving third party and gathers all information necessary to file hospital lien in timely manner. Files satisfaction of lien.
As needed, sends letters to patients to request additional information for payment of claims.
Process late charges within standard timeframe.
Primary point of contact regarding all billing for the office including insurance, 3rd party claims and other types of billing matters.
Must be able to perform the physical demands of the job.
Maintains regular and reliable attendance.
High school diploma, GED or equivalent.
Required to show proof of having completed Mandatory Reporter course at time of hire or attend within 6 months of start date.
PC proficiency with IP and OP hospital insurance claims filing and reimbursement principles desired.
Knowledge of ICD.9, CPT and HCPC coding classification systems desired.