Billing/Collections Specialist

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Job Type

Full-time

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.