Billing Specialist II (60791)

Job Summary: The Medical Billing Specialist II is primarily responsible ensuring revenue cycle objectives are met by assisting with special projects, training, billing and resolution of denials.for the resolution of denied claims and developing strategies to optimize billable encounters.

Essential Functions:

• Responsible for all special projects assigned from leadership

• Provide training as needed related to billing processes

• Identify and resolve complex claims and billing issues. (including payer-rejected claims).

• Investigate payer- rejected claims to determine reason for denial.

• and work to obtain resolution.

• Determine strategies to reduce denials based on denial reasons, changing laws and practices.

• Prioritize and work HOLD an MGR HOLD buckets.

• Monitor claim rejections percentages and report denial percentages regularly.

• Prepare reports out of the EHR system as needed.

• Regularly interact and assist in training of the front desk staff concerning patient insurance eligibility.

• Support the revenue cycle by ensuring claims are dropped within 3 business days of service.

• Performs other duties as required.