Billing Specialist

Position : Billing Specialist

Department : Revenue Cycle Management

Objective

The billing specialist will ensure that claims go out in a timely and accurate manner. They will use their billing and coding knowledge to confirm clean claims are being accepted by the clearinghouse and payor and work on any rejections or corrected claims as needed.

The billing specialist must have a solid grasp on progressional billing in order to identify billing errors and proactively communicate and fix set-up or billing issues that prevent clean claims from going out the door.

Reporting Relationship

RCM Supervisor & RCM Manager

Scope of Supervision

N / A

Responsibilities

• Bill assigned sites daily within 48 hours of treatment
• Review claims prior to submission to confirm coding and billing guidelines are met
• Monitor and track all claims to ensure successful transmission.
• Review and correct claims returned or rejected by the clearinghouse.
• Manage billing and exception queues including the billing discrepancy report, pending rebills / corrections, and no claim on file report
• Perform month end tasks and reporting such as updating the month-end tracker
• Document any billing errors and corrections done and report necessary claims on the issues detail tracker
• Communicate any system set-up issues and assist in finding and implementing the resolution
• Stay informed of new billing guidelines and coding updates.
• Research billing requirements of new drugs.
• Perform other duties as assigned by supervisor.

Minimum Qualifications

• Knowledge of CPT, HCPCS, and ICD-10 coding
• Expertise in health insurance billing rules and regulations
• Understanding payor requirements
• Previous medical billing and claims collection experience
• Ability to evaluate options and to make efficient decisions
• Strong written and verbal communication
• Infusion background a plus
• Exhibit overall behavior and actions that demonstrate willingness to learn, be coached, and take accountability for self-improvement and growth;

be a collaborative team player

Job Posted by ApplicantPro