Insurance Billing Specialist, Full-time

Insurance Billing Specialist

We are currently looking for experienced Insurance Billing Specialists. Must be willing to reasonably commute to Hopedale IL, this is not a remote position.

Obtain accurate, ethical, and optimal reimbursement for hospital and hospital-based services, initiate follow-up of past due balances, handle all components of claims processing including management of disputed, rejected, and delayed claims. Develop a thorough understanding of third-party reimbursement requirements. Enter and electronically or hard copy submit billing data, as necessary. Know and understand all policies and procedures of Insurance Billing. Must be a problem solver, have organizational skills, attention to detail, excellent telephone technique and rapport, and computer knowledge.

Responsibilities

• Insurance Claim Billing
• Reviews patient accounts and verifies data for correct billable services and fees. Ensures all pertinent billing information is documented to produce a clean UB-04 claim.
• Runs daily insurance billing reports and reviews discrepancies. Corrects accounts, as necessary.
• Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.
• Prior to submission, reviews each claim for accuracy and missing information. Transmits claims electronically to TruBridge.
• Insurance Claim Follow up
• Follow up on any unpaid claim.
• Follow-up on insurance denials and takes appropriate steps to resolve discrepancies.
• Communicates discrepancies and the need for additional information to the appropriate parties. Obtain supporting documentation to appeal claim payment.
• All collection and follow-up efforts will be annotated in the CPSI computer System.
• Re-bill accounts as needed.
• Ensure accurate Insurance Payments are received
• Receive daily incoming payments and prepare for posting. Review explanation of benefits and verify patient information, payer, and date of service for all transactions.
• Audit payments against contract terms.
• Compute contractual allowances as needed.
• Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off.
• Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.
• Accounts Receivable Management
• Monitor and maintain assigned Accounts Receivable at minimal levels.
• All assigned accounts are regularly worked and followed up on.
• Ensure any credit balances are resolved and generate refund requests for over payment as soon as possible.
• Other Duties as Assigned
• Keep updated on all third-party billing requirements. Serves as a resource person for staff inquiries regarding billing issues.
• Assists with training of staff as necessary.

Knowledge / Skill / Ability Requirements