We are looking for a Billing Specialist to compile, compute, and record billing ensuring accurate and timely completion and submission of claims, billing, and collection of payments for services. This includes but not limited to reviewing, researching, investigating, negotiating, processing, and adjusting all claims including denied claims.
Our Billing Specialist must possess excellent communication skills with attention to detail while fostering positive relationships with our customers. Have exceptional critical thinking skills and the ability to multitask adhering to strict policies and deadlines.
Equivalent to an associate degree is preferred. One to three years of verifiable work history including experience in medical billing is required.
Accurately submit medical claims to insurance companies and payers such as Medicare and Medicaid.
Update patient data, prepare invoices and develop payment plans.
Review patient bills for completeness and accuracy, applying proper coding procedures and collecting missing information.
Prepare, review, and transmit claims using medical billing software, including electronic and paper claim processing.
Follow up on unpaid claims within standard billing cycle.
Research and verify insurance payments for accuracy, adhering to contract cost principles and procedures.
Contact insurance companies to file an appeal regarding payment disagreements and/or discrepancies.
Identify and bill secondary or tertiary insurances.
Accurately enters and setups up client payment plans and assists with collection accounts.
Performs other specific projects relating to billing, data entry, and computer operations.
2-3 years of experience in billing government funded payers, such as Medicaid, and Health Maintenance Organization (HMO)
2-3 years of experience in processing E-claim/E-file.
2-3 years of experience in working with software aggregators such as WellSky.
Knowledge of applicable laws, regulations, and compliance requirements to ensure that claims are processed properly (e.g., HIPAA, PPACA/Health Care Reform, state-specific regulations/grievance procedures, TAT)
Effective oral and written communications and presentation skills are essential, as are interpersonal skills.
Knowledge of ICD-10 and CPT coding.
Ability to gather and analyze statistical data and generate reports and to plan, coordinate and administer complex administrative systems and processes.
Demonstrated ability to work independently and use sound judgment and discretion successfully.
Strong computer skills with proficiency in software applications, such as Word, Excel, PowerPoint, and Electronic Medical Records.
Caretruly Healthcare is an equal opportunity employer
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