Billing Specialist

Job Description

The Weston Group is looking for a Full Time Billing Specialist in our Forks Township office in PA.

The Billing Specialist must have knowledge of billing Medicare and third-party insurance facility and professional claims by hard copy and electronically. Must have knowledge of Medicare and third-party billing requirements. Good verbal and written communication skills are essential.

JOB RESPONSIBILITIES:

1. Prepares and submits facility and physician-based claims to Medicare and third-party insurance carriers

2. Follows-up with Medicare and third-party insurance carriers on unpaid claims till claims are paid.

3. Processes rejections by either making accounts private or generating a letter of rejection to patient or correct any billing error and resubmitting claims to Medicare and third-party insurance carriers.

4. Works with Clinical Staff and Management to ensure that correct diagnosis/procedures are reported to Medicare and third-party insurance carriers.

5. Makes accounts private and notify patients when claims have not been paid after time frames in established accounts receivable policy.

6. Keeps updated on all billing and benefit changes for Medicare and third-party insurance carriers.

7. Posts Medicare and third-party insurance remittance vouchers.

8. Assists patients, clinical staff, and outside customers with problems or questions regarding their claims and or services.

9. Secures needed medical documentation required by third party insurances.

10. Monitors claims for missing information, authorization.

11. Maintains confidentiality of all information.

12. Completes work within authorized time to assure compliance with department standards.

13. Demonstrates knowledge of, and supports, The Weston Group, Inc. mission, vision, value statements, standards, policies and procedures, confidentiality standards, and the code of ethical behavior in the workplace.

14. All other duties as assigned.

EXPERIENCE:

Insurance collections, claims and appeals: 3 years

Accounts receivable: 3 years

EDUCATION:

Highschool Diploma or GED

Higher education is preferred, but not required

Full-time