Billing Specialist

Job Description

Job Description

POSITION SUMMARY

The Billing Specialist is responsible for FCHC’s third party medical claims processing. Medical claims are prepared and submitted to Medicaid, Medicare, and private insurance companies. This position will handle questions, complaints, or problems from insurance companies, Medicaid offices and their associated Managed Care Plans, Medicare regions and their associated Health Maintenance Organizations, and families regarding insurance payments. Research, resolves, and resubmits denied claims and takes timely and routine action to collect unpaid claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES

The Billing Specialist job duties also include, but are not limited to :

Claim Submission :

• Create and process medical claims
• Verify compliance of all medical claims
• Maintain constant communication with insurance carriers to ensure a clear and concise claim process for claims to be processed quickly and efficiently.
• Issue Explanation of Bill to patients and interpret balances in which the patient is responsible for payment
• Accurately documents patient accounts of all actions taken.
• Educates clinic management and staff regarding changes to insurance and regulatory requirements.
• Actively participates in practice management meetings.
• Completes additional projects and duties as assigned.

Job duties are subject to change based on company needs

Claim Follow-up :

Review denial report and correct claims and resubmit to insurance.

Administrative & Miscellaneous :

EDUCATION, TRAINING AND EXPERIENCE

Minimum Qualifications :

Demonstrates overall knowledge of claims processing for various insurances both private and governed.