Billing Specialist

Job Description

Position Summary

Responsibilities involve billing of institutional and professional claims to various insurance companies/payers. The biller will audit and conduct all research relating to meeting payer billing guidelines for clean claims submission. Will include the handling of the billing function for multiple facilities as assigned.

Primary Duties and Responsibilities

Submission of clean claims per billing frequency as assigned by management.

Assist with the coverage of the other facilities, as needed.

Maintain correct and specific billing guidelines and relay any updates needed to management.

Reconcile charges in patient accounting system to ensure that all billable charges are capture and submitted within the appropriate time frame.

Handles rebill requests and assist with billing projects as assigned.

Review and correct billing edits in Waystar in order for the claim to be released for submission.

Assist in month-end close.

Be knowledgeable of all managed care organizations (MCO)

Accept responsibility for professional growth and development of self.

Support facility wide performance improvement goals and objectives.

Other duties as assigned.

Job Qualifications and Requirements

Education:

A high school diploma or an equivalent combination of education, experience, and training that provides the required knowledge, skills and abilities is required.

Experience:

Five (5) years of Business Office experience preferred with at least two (2) of those years involving healthcare office management.

One (1) year of experience in a billing practice including exposure to verification, certification, authorization, managed care, revenue capture and relationship building with payers.

Knowledge/Skills/Abilities:

Knowledge of medical terminology and an ability to accurately record payables, receivables, collections and data related to operations of the facility.

Excellent oral and written communication in English; ability to perform routine numerical calculations for compiling various reports; and ability to exercise good judgment and discretion in all interpersonal contact.