Billing Specialist

Overview:

Responsible for the billing of claims and resolving claim issues for commercial and government 
insurances by following the approved processes, policies and procedures set by the Regional 
Billing Organization

 

Responsibilities:

• Prepare and correct claims to cleanly pass from the EMR to clearinghouse.
• Perform posting charges and completion of claims to payers in a timely fashion.
• Resolve patient accounts through the correction of billing edits and clearinghouse rejections.
• Navigate portals to send claims for adjudication.
• Prepare invoices to send to third party payers.
• Prepare enrollments to send claims through the clearinghouse.
• Analyze and identify trends to reduce the number of claim denials.
• Communicate clearly and in a positive manner with assigned staff.
• Provide excellent customer service to team members and patients.
• Meets important deadlines consistently especially during end-of-month/EOM closings.
• Supports the team in reaching or exceeding target goals for productivity.
• Participates in continuing educational activities relative to assigned duties and responsibilities.

Qualifications:

• High school diploma or GED required.
• Minimum 5 years of medical billing experience
• Computer proficiency and experience in Windows-based technologies
• Ability to be discreet and protect patient PHI.
• Prior work experience in a medical office setting preferred.
• Excellent problem-solving skills, attention to detail, management of multiple tasks and the 
ability to do so independently.
• Ability to handle difficult situations with a positive attitude.
• Good interpersonal, oral, and written communication skills.
• Must be able to work as part of a team with peers and leadership within the organization