Billing/Collections Specialist
Job Description
Job Description
Description :
Job Summary : Responsible for submitting claims, appeals, and following up on outstanding balances from the patients insurance.
Responsible for solving all claim denials.
Essential Duties and Responsibilities : The essential duties of the position include the following. Other duties may be assigned.
Key Functions :
- Prepares and submit clean claims to various insurance companies either electronically or on paper.
- Contact carriers by phone or website for claim status on outstanding insurance balances.
- Process and work all insurance correspondence.
- Perform various collection actions including contacting patients by phone, correct and resubmitting claims to other carriers.
- Obtain necessary documentation required to submit to insurance to expedite payments.
- Answers questions from patients, clerical staff and insurance companies.
- Identify and resolve patient billing complaints.
- Prepare appeal letters for all claims that are denied for payment.
- Document all collection activities using guidelines in place.
- Identify underpayments by checking payments received against our contracted fee schedule.
- Work and process all insurance refund requests.
- Report payer issues or delays to supervisor.
- Participate in educational activities
- Maintains strict confidentiality; adhere to all HIPAA guidelines / regulations.
- Team Player with ability to solve problems and recommend solutions.
- Must be able to manage assigned workload and prioritize accordingly.
- Maintain accurate and timely reconciliation of accounts receivable.
- Review claims stopped in the claim scrubber.
- Work Claims rejected by the clearinghouse.
Requirements :
Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education / Experience : High School Diploma or GED, and minimum one year experience in a medical billing / collections field.