Billing Specialist

Job Summary:

The Medical Billing Specialist performs complex clerical and accounting functions for patient billing including verification of benefits, maintenance of insurance billing records and resolution of problems. Follow up on claims and patient bills, resubmit claims or correct errors. May handle accounts receivable posting. Works with others in a team environment.

Role is mostly remote but will need to travel to locations to provide training as needed. Candidate must be located in Eastern PA 

Essential Duties and Responsibilities:

• Process bills with electronic practice management system to insurance and patients.
• Maintain notes, supporting documentation and current patient policy and address information.
• Monitor submitted claims; follow up on unpaid claims through regular work of AR reports; initiate dialogue with insurance companies.
• Resubmit claims to insurance companies as necessary
• Post and reconcile payments to patient ledger
• Answer questions from patients, staff, and insurance companies
• Identifies and resolves patient billing complaints
• Evaluates patient’s financial status and establishes budget payment plans
• Follows and reports status of delinquent accounts
• May perform collections actions such as contacting patients by phone or generating collection letters.
• Works with front desk staff to ensure correct billing
• Maintains confidentiality and adheres to all HIPAA guidelines.
• May be required to assist with pre-certs, prior auth and pre-cert experience helpful.
• Handle patient phone calls concerning current balances, past due accounts, and collection balances.
• Post patient payments
• Prepare patient chart for billing and collections
• Answer inquires regarding balances / credits of patients to Front Desk staff
• Post other forms of payment as necessary (monthly, weekly, daily)
• Provides relief for Pre-Certification as needed
• Perform other duties as assigned

Education, Skills, and Experience:

• High School diploma or equivalent required, bachelor’s desired
• Prior experience in medical billing and insurance follow up reimbursement (minimum: 3+ years)
• Basic comfort level with Internet and MS Office environments (Word, Excel, Outlook) required
• Knowledge of patient billing terminology, collections, as well as government regulations
• Working knowledge of CPT and ICD-10-CM codes and electronic claim filing
• Highly organized with strong attention to detail
• Ability to problem-solve and identify billing trends and patterns
• Ability to manage multiple assignments and balance workload independently
• Strong communications skills; ability to listen attentively and to communicate clearly and effectively
• Must be a dependable team-player with a positive attitude
• High degree of drive, initiative, and follow-through