Job Posting
Billing Specialist- Full Time
Major Roles & Responsibilities
Purpose: The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts.
Additionally:
• Enters information necessary for insurance claims such as patient, insurance, and insurance ID. Insures claim information in complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
• Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
• Work with patient to establish payment plan for past due accounts in accordance with provider policies, as needed.
• Follows HIPAA guidelines in handling patient information.
• Provides necessary information as needed to collection agencies for delinquent or past due accounts.
• Post insurance and patient payments using medical claim billing software.
• May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• Prepares and submits secondary claims upon processing by primary insurer.
• Understand managed care authorizations and limits to coverage such as number of visits.
• Verify patient benefits eligibility and coverage as needed.
Academic, Certifications, & Trade Qualifications
• High School diploma or GED required.
• Billing experience preferred.
Additional Information
Position Type : Full Time
Shift : Day
Contact Information
Michael Gruenberg - Revenue Cycle Director
SMDH
Email: mgruenberg@smdh.net |
