Billing Specialist Physician Group-Woods Cross

Responsibilities and Duties

• Submit approved claims for submission and ensure proper acceptance (as assigned)
• Denial Resolution: researching, resolving, and resubmitting denied claims; taking timely and routine action to collect unpaid claims; and interpreting various forms of explanations of benefits (EOBs) from insurance carriers
• Work with team/office in identifying, researching, and resolving issues which may lead to inaccurate or untimely filing of claims, claim rejections, and/or other billing and collections issues which may arise
• Assist management/education team in providing training, assistance, and/or guidance to other staff members in issues of accounts resolution through billing, collections, and/or denial processing techniques
• Compile and re-submit claims to insurance companies based on data provided by the office and/or clinical staff
• Review first initial claim scrub and billing to the clearinghouse utilizing billing and EMR software
• Validate claims and make necessary corrections to send out clean claims to the payers electronically and/or via paper
• Employ effective and efficient billing techniques, and self-directed initiative, to resolve all types of billing edits, or denials
• Resolve disputed balances in our billing and EMR software
• Work with management and other revenue cycle staff to improve processes to increase accuracy and efficiency
• Send appeals as necessary.
• Investigate all claims on AR reports for assigned office location(s)
• Responsible for the successful collection of all revenue for assigned office location(s)
• Monthly variance review of assigned location(s)
• Assist all callers as necessary in a professional manner, transfer call when appropriate and promote excellent customer service
• Correspond with Supervisor regarding compliance, billing issues, and AR trends that arise during daily work
• Interact with all RCM teams in organizing, and implementing processes and activities

Job Qualifications Title

Qualifications

Job Qualifications

Qualifications

• A minimum of 1 year of billing/revenue cycle/accounts receivable experience in a healthcare setting.
• Strong accounts receivable and collection skills.
• Strong Customer Service Skills
• Self-motivated drive to complete outstanding tasks
• Independent worker that is able to manage time efficiently.
• Proficient computer skills – especially Microsoft office products
• Accounts receivable or medical payment posting experience
• Working Knowledge of EMR and Billing Systems
• Strong problem-solving skills
• Strong communication skills

Job Type: Full-time

Required Qualifications

1. High School diploma is preferred.
2. Experience in accounts receivable functions.
3. Must have at least 1-3 three years of billing experience in a hospital, nursing home, assisted living or other related health care facility.
4. Knowledgeable of assisted living facility billing requirements including Medicaid (New Choice Waiver) and/or applicable insurance plans.
5. Strong organizational and communication skills
6. Customer service