Billing Specialist

Overview:

Responsible for the day-to-day operations related to billing and collections.

Duties and Responsibilities:

• Computes patient fees and charges.
• Collects payments from patients.
• Establishes and follows up on patient payment plans.
• Compiles billing data from electronic health record system, practice management systems, and other databases.
• Prepares and submits electronic claims to third party payers.
• Investigates and follows up with rejected claims.
• Maintains current knowledge of the basic and major medical, behavioral health, and prescription coverage plans.
• Maintains current knowledge associated with the billing methodologies of each plan.
• Performs insurance coverage and grant eligibility verifications by making field calls or using other verification tools.
• Generates superbill for appropriately covered patients three days before patient visit.
• Forwards verification information to Medical Receptionist at least two days before patient visit.
• Schedules follow up visits for providers.
• Assists financial team with clerical tasks.
• Participates in quality management and quality assurance activities.
• Other tasks as assigned by the Director, Revenue Cycle and Billing.

Education, Experience, Licensure/Certification and Skills/Abilities Related Requirements:

High School Diploma required. Associates Degree preferred. At least four (4) years of practical work experience. Must have paid experience with medical claims coding/billing and medical insurance industry. Each additional year of practical work experience beyond the required four (4) years can be substituted for one (1) year of college.

Continuing Education and Training Requirements:

Participates in trainings required by the funding source and/or as required by licensure