Insurance Billing Specialist

Insurance Billing Specialist, Onsite

We are currently looking for experienced 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.