Summary
The Billing Specialist is responsible for handling a variety of financial and non-financial tasks in order to help guarantee the agency's revenues.
Role ad Responsibilities
- Verify insurance eligibility and coverage;
- Submit claims to payers in a timely manner;
- Process insurance claims for Medicaid and private insurance reimbursement;
- Resolve billing issues and reprocess claims as needed;
- Determine status of claims;
- Follow up with insurance carriers for continuous claims reimbursement;
- Verify patient data, statistics, and charges to reduce denial rates;
- Maintain the agency’s billing and third party billing systems (ROCS, DARTS, and Carelogic);
- Troubleshoot denied claims and billing errors and make appropriate corrections
- Follow up on unpaid claims;
- Document payment records and issues as they occur;
- Adhere to and enforce all agency policies and department procedures;
- Prepare reports and complete authorizations requested by payers;
- Send daily and weekly reports to department directors on status of claims;
- Appeal unprocessed and/or unpaid claims to the appropriate insurance carrier;
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
This job description reflects the assignment of some essential functions of the job; however nothing restricts management’s right to assign or reassign duties and responsibilities to the job at any time.
Qualifications
- High diploma or equivalent required; some college preferred;
- Billing/coding certification preferred;
- 5-7 years of verifiable experience with medical billing and coding required;
- Experience with Waystar (formerly Zirmed) and Carelogic a plus;
- Computer and Microsoft Office proficiency.
Job Type: Full-time
Pay: From $45,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Health insurance
- Life insurance
- Paid time off
- Tuition reimbursement
- Vision insurance
Schedule:
Application Question(s):
- Do you have experience with Waystar (formerly Zirmed) andm or Carelogic ?
- How many years of billing experience do you have?
Education:
- High school or equivalent (Required)
Experience:
- Medical billing and coding: 5 years (Preferred)
Work Location: In person