Billing Specialist

Job Description

Job Description

Summary :

The Billing Specialist may be required to fulfill key billing aspects including but not limited to : primary and secondary claims per regulations and policies, re-processing of denials of claims, and ensuring billing and coding are accurate and correct.

Essential Duties / Responsibilities :

• Responsible for the submission or resubmission of primary, secondary, and tertiary claims per respective regulations and policies.
• Ensures billing and coding are correct prior to sending appeals or reconsiderations to payers.
• Complete insurance verification.
• Investigate un-adjudicated claims and complete appropriate follow-up
• Greet and provide assistance, guidance and direction to visitors and clients.
• Clearly document issues and resolution.
• Communicate with third-party representatives as necessary to complete claims processing and / or resolve problem claims.
• Maintains confidentiality and adheres to all HIPAA guidelines / regulations.
• Exhibit exceptional customer service skills; answering patient and insurance calls; prompt return and follow up to all interactions; prompt response to requests for information

Non-Essential Duties / Responsibilities :

Required Competencies and Experience :

Physical Requirements :

Working Environment :