Billing Specialist

ESSENTIALFUNCTIONS

• Collect payments for outstanding claims and ensure payments received are reconciled correctly.
• Research insurance denials and submit corrections.
• Maintain knowledge of current government and carrier regulations relevant to the industry.
• Ability to read/interpret EOBs.
• Communicate clearly and professionally, in both written and verbal manners with internal personnel, payors, providers, patients and other authorized representatives in regard to outstanding balances.
• Identify and report trends in carrier payments and denials, which includes documentation of actions taken to resolve issues.

• Review and take appropriate action against correspondence (including EOBs, RAs, denial letters) within a timely manner.
• Responsible for all aspects of follow up and collections on accounts. This includes making outbound calls to payers and accessing payer websites.

KNOWLEDGE,SKILLS AND ABILITIES

• High school diploma or GED required.
• Three-year experience with appeal submissions and/or accredited 4-year college degree and/or medical billing/coding certificate.
• An overall understanding of the insurance billing and denial process through completion.
• Exemplary customer service skills
• Attention to detail and ability to complete the job with minimal errors.
• Excellent oral and written communication skills
• Ability to prioritize and manage time effectively.
• Ability to maintain confidentiality.
• Proficient with Microsoft Office: Word, Excel, and Outlook
• Knowledge of HIPAA guidelines
• Strong research and problem solving abilities