Job Summary: The Billing Specialist is responsible for overseeing the entire billing process for patient accounts, from submitting all billings to insurance in a timely manner, to working with our coding specialist to ensure that all cases are coded correctly, leading monthly coding audits, and taking the lead role in driving insurance collections. 

• Essential Job Duties and Responsibilities include the following:

• Electronically submit patient procedure bills to third party payers

• Perform timely and accurate postings of payments received from third party payers and/or patients

• Perform timely and accurate processing of all rejected and denied claims submitted to third party payers

• Contact insurance companies to collect outstanding payments

• Monitor and collection of AR aging

• Knowledge of how to interpret a managed care contract, Medicare and Medicaid, and Workers Compensation claims is a must

• Identification of accounts that have been either under or over paid

•  Issuing credit balance information either to the insurance carrier or the patient

• Excellent communication and negotiation skills

• Ability to work independently and interdependently with other business office staff

Required Skills: 

High School Diploma or equivalency

At least 3 years of experience in medical billings, with an extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc.

Extensive knowledge of billing, collections and reimbursement of claims processing

Fluent in medical terminology and CPT codes

Ability to work independently

Organization, time management and task prioritization abilities

Ability to be discreet and maintain the security of patient information

Excellent verbal & written communication skills, and interpersonal skills

Excellent customer service skills, always demonstrating professionalism

Comfortable utilizing critical thinking skills

Proficient with Microsoft Office products

Understanding of healthcare specific policies, such as HIPAA regulations