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Insurance Billing Specialist, Onsite

Insurance Billing Specialist, Onsite

Hopedale Medical ComplexHopedale, IL, United States
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Insurance Billing Specialist, Onsite

We are currently looking for experiences Insurance Billing Specialist!

Must be willing to reasonably commute to Hopedale IL, this is not a remote position.

Job Preview

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 :

1 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.

2 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.
  • 3 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.
  • 4 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.
  • 5 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.
  • Other duties as assigned.
  • Knowledge / Skill / Ability Requirements :

  • Minimum of High School Diploma. Some college preferred.
  • Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.
  • Knowledge of medical billing / collection procedures.
  • Prefer 1-2 years in medical business office including Insurance Claim follow up.
  • Demonstrated working knowledge of a computerized medical information management system.
  • Skills in Microsoft Office Suite (Word, Excel, Outlook).
  • Good verbal and written communication skills required.
  • Ability to work independently with only general supervision.
  • Great attention to detail required along with a high level of dependability.
  • Excellent telephone techniques and rapport.
  • Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.
  • Compensation details : 25-27 Hourly Wage

    PIdc86490f2ac0-29400-38471877

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    Billing Specialist • Hopedale, IL, United States

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