Billing & Collection Specialist

The Department of Neurology is seeking a

Billing & Collection Specialist who will be responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU / PBS billing applications.

Specific Duties & Responsibilities

• Work with payers to resolve issues and facilitate prompt payment of claims.
• Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper.
• The Specialist will be assigned pay or groups of outstanding patient accounts.
• Various methods of follow-up will be used including all JHU / PBS Billing Applications.
• Use NR follow-up systems and reports to identify unpaid claims for collection / appeal.
• Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
• Review and update patient registration information (demographic and insurance) as needed. Apply appropriate discounts I courtesies based on department policy.
• Prepare delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
• Print and mail claim forms and statements according to the follow-up matrix.
• Retrieve supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers.
• Appeal reflected claims and claims with low reimbursement.
• Confirm credit balances and gathers necessary documentation for processing refund.
• Identify insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
• Contact the payers or patient as appropriate for corrective action to resolve the issue and receive payment of claims.
• Monitor invoice activity until problem is resolved.
• Process daily mail, edit reports, file or pull EOB batches.
• Identify and inform the supervisor I Production Unit Manager of issues or problems associated with non-payment of claims.
• Perform other duties as required.

Minimum Qualifications

• High School Diploma or GED required.
• One year experience in a medical billing or similar environment required.
• Knowledge of medical terminology, CPT codes and diagnosis coding required.
• Additional education beyond minimum experience qualifications may substitute for required experience to the extent permitted by the JHU equivalency formula.

Classified Title : Billing & Collection Specialist

Role / Level / Range : ATO 40 / E / 02 / OC

Starting Salary Range : $15.50 - $25.00 HRLY (Commensurate with experience)

Employee group : Full Time

Schedule : M-F 8 : 30 am - 5 : 00 pm

Exempt Status : Non-Exempt

Location : Remote

Department name : SOM Neuro Production Unit Billing

Personnel area : School of Medicine