Billing Specialist

We are an organization that provides services to individuals (adolescent, adult) and families within our facility and the families’ home, school, and community.

The Billing Specialist utilizes knowledge of insurance regulations; including but not limited to—medical coding, insurance verification, preparing deposits, collecting, posting, and managing account payments, submitting accurate claims, and following up on accounts. Experience with systems such as ---------- , Availity, and Optum provider express is a plus. Understanding of CPT codes, rejection codes and the re-processing of rejected claims is necessary.

Duties & Responsibilities:

• Working directly with the insurance company, healthcare provider, and patient to get claims processed and paid.

• Reviewing unpaid and denied claims. Helping management process EOBs to patient accounts.

• Verifying patients’ insurance coverage. Make recommendation to management for write-offs.

• Answering patients’ billing questions, responding to patient billing and statement inquires.

• Resubmit claims for any non-paid CPT codes.

• Call patients regarding their account balances.

• Answering patients’ billing questions.

• Resolves problems prior to claim submission and assist with post submission problem resolution by obtaining information and correcting data.

*. Bill Weekly claims to the necessary funding source and input remittances into EMR (Electronic Medical Record) system

*. Track data and progress of unpaid calims.

• Any other duties as assigned by Finance Manager and Executive Team.