Billing Specialist

Accurately process insurance claims, prompt pay and client billing for pathology procedures.Collect and post payments received from multiple sources and document all transactions.Manage issues and problems effectively for the best outcome for the company, our clients and patients.

Key Job Functions:

1. Follow the Revenue Cycle workflow
2. Ensure accurate and complete patient demographics are captured in the billing software. Communicate updates to administrative staff when discrepancies occur.
3. Verifying eligibility and coordination of benefits. Making updates as necessary for clean claim submission.
4. Scrub all new claims and resubmissions for accuracy in coding based on payer, rendering provider and billing group.
5. Post payments and adjustments received from payers
6. Work assigned and unassigned denials in a timely manner.
7. Follow up on all unpaid claims by contacting the payer or utilizing online provider portals.
8. Identify trends in denials, payment and non-payment and communicate issues to management and team.
9. Research, document and resolve issues to assure payment.
10. Follow up on all paper and electronic correspondence from payers and patients.
11. Interact with insurance companies, clients and patients to support the payment process.

Qualifications:

• High School Diploma or GED required. Certificate in healthcare billing preferred
• Two years in billing/coding experience within the last five years
• Accurate 10-key ability
• Knowledge of EOBs, CPT & ICD-10 codes, HCFAs, CMS1500, HCPCS
• Experience in researching denials and how to resolve for payment
• Knowledge of government and commercial insurance billing, appeals, and prior authorization

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