Billing Specialist

Job Responsibilities

• Prepare and submit claims to assigned insurance companies
• Analyze, correct, and resolve claims edits related to billing, charging, and registration errors promptly and accurately to ensure clean claims are submitted in a timely manner.
• Review charges and verify appropriate usage of modifiers, CPT codes and ICD-10 codes prior to billing.
• Research, as necessary, any payer-specific billing and reimbursement rules, including but not limited to Correct Coding Initiative (CCI) edits.
• Resolve clearinghouse rejections and errors.
• Works in Epic EMR to make all claims corrections and resubmits claims when appropriate.
• Monitors claim edit work queues to ensure claims are resolved and submitted within 24 hours.
• Proactively communicates problems or issues in a timely manner for continuous workflow.
• Other duties as assigned.

Education Requirements

• High school diploma or GED

Experience Requirements

• Minimum: One (1) year of experience working with insurance balances in a business office or similar role.
• Preferred: Two (2) years of billing experience working in Epic EMR

License/Certification Requirements

• None