Job Description

The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts. Reports to the Billing Supervisor. Essential Duties and Responsibilities include entering information necessary for insurance claims such as patient, insurance, and insurance ID, ensuring claim information is complete and accurate, submitting insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form, answering patient questions on patient responsible portions, copays, deductibles, write-offs, resolving patient's complaints or explaining why certain services are not covered, following up with insurance company on unpaid or rejected claims, resolving issues and re-submitting claims, preparing appeal letters to insurance carrier when not in agreement with claim denial, collecting necessary information to accompany letter, following HIPAA guidelines in handling patient information, performing "soft" collections for patient past due accounts including contacting and notifying patients via phone or mail, understanding managed care authorizations and limits to coverage such as number of visits, verifying patient benefits eligibility and coverage as needed, and preparing and submitting secondary claims upon processing by primary insurer. The role requires integrity, compassion, innovation, and philanthropy. Job qualifications include a High School Diploma or GED, medical billing experience highly preferred, experience in billing software and electronic data submission preferred. Mental/Physical requirements include ability to receive and express detailed information through oral communications, visual acuity, ability to read and understand written directions, normal mental concentration with repetitive operations for a long period of time, ability to stand, walk, sit, and reach, and occasionally lifting and transporting items weighing up to ten pounds. Working conditions are standard office conditions with more than average noise and periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases.

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