Billing Specialist I

Base Pay Range:

Job Description:

The Billing Specialist is a Full Time, Regular Project position. Hours of training are 9am-5:30pm CST and hours after training are 8am-4:30pm CST at the Navani Business Center, a wholly owned Inland Imaging company in Arlington, TX.

Summary:  Responsible for addressing large volumes of unpaid or incorrectly paid claims to secure accurate and timely reimbursement. The Billing Specialist I performs advanced claim follow-up, denial resolution and payer issue management with a high degree of accuracy and independence.

General Description:  The Billing Specialist I performs complex medical billing functions related to third-party claims. This includes reviewing unpaid claims and denials, rebilling as needed, analyzing payer trends, resolving credit balances, researching patient claim concerns and coordinating solutions for systemic payer issues.

Essential Duties/Responsibilities: To perform this job successfully, an individual must be able to perform each duty satisfactorily. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.

• Reviews unpaid claims by calling for payment status, submitting appeals, and correcting / resubmitting claims when necessary.           
• Follows up with insurance companies for any unpaid or incorrectly paid services.
• Assists patients with insurance questions when Billing Customer Service Specialist is not available.
• Writes off uncollectible balances with dollar values as high as $500 (dependent on experience).
• Resolves claim edits (missing claim information) prior to the submission of the claim to insurance companies.
• Works with vendors to resolve payer issues.
• Corrects posting discrepancies to align with payer adjudication.
• Researches payments received but not yet posted.
• Coordinates with credentialing liaison to address provider enrollment issues.
• Attends monthly meetings to stay updated on policies, upcoming changes and communicates relevant information to leadership.
• Works with referring physician offices to obtain retroactive authorizations or referral numbers.
• Contacts clients regarding overdue accounts, provides requested information and communicates charge discrepancies to leadership.
• Participates in peer-to-peer training and quality assurance activities.
• Supports the LLC staff with onsite eligibility inquiries as needed.
• Performs special projects and additional duties as assigned.

General Duties/Responsibilities:

• Ability to maintain strict confidentiality within the Inland Imaging companies and Inland’s customers.
• Honest, pleasant manner and good personal hygiene.
• Free of alcohol and drug abuse.
• Ability to access multiple worksites in a timely manner.
• Excellent communication and interpersonal skills.
• Detail oriented; ability to multi-task; organized and able to work in a fast-paced environment.
• Demonstrates self-directed learning and participation in continuing education through professional journals, approved seminars, etc.

• Adheres to departmental standards and personnel policies by demonstrating professional demeanor in conduct and appearance.
• Follows company departmental standards and personnel policies by using good teamwork and communication skills to help identify concerns and solutions, assisting where needed to ensure a smooth functioning department.
• Follows all Health and Safety policies and guidelines of Inland Imaging and its partners depending on work location
• Performs other duties as required by displaying team spirit and self-growth, accepting and performing other projects and responsibilities, and requesting other projects and responsibilities.
• Ability to work remotely, from a home-based environment with desk, desk chair, computer, adequate lighting, and access to cable internet.
• Requires flexibility with scheduled work hours the final week of the month/year to ensure all available dollars are posted to client A/R system by close of business.

Supervisory Responsibilities:

• There is little or no supervisory responsibility in this position.

Advocacy:

Treats all clients with dignity and respect Provides excellent customer service Conforms to Joint Commission and HIPAA regulations Complies with PHI (Protected Health Information) Demonstrates the Inland Imaging Core Values:

• Show We Care, Do The Right Thing, Maximize Individual Potential, Always Aim Higher

Qualifications:

• Education:  High School Diploma/GED Required
  • Two years medical billing course preferred
• Experience:
  • Strong customer services skills required
  • Working knowledge of Imagine Software or other patient accounting systems preferred
  • CPT and ICD-10 coding experience preferred
  • Good customer service skills preferred
• Licensure:   N/A
• Certifications:  N/A
• Computer Skills: Experience with the following computer applications is highly desired: Microsoft Office Suite (Outlook, Word, Excel), Workday, Internet/Intranet, Meditech, Code Correct, Medinformatix, Imagine, PhiCure, Waystar.
• Background Check:
  • Must be able to pass a background check required by RCW 43.43.830-840 to work with children under the age of 16, developmentally disabled persons or vulnerable adults
  • In order to comply with provisions set forth in Sections 1128 and 1156 of the Social Security Act, all new employees of Inland Imaging Business Associates will be checked against the LIST OF EXCLUDED INDIVIDUALS provided by the Department of Health & Human Services, Office of the Inspector General (OIG).  Employees must not be included on this list.  
• Drug Test: Eligible employees must be able to pass a post-offer, pre-employment drug test including marijuana.

Nuvodia/Inland is an EEO employer...