Responsibilities:
Monday - Friday : 8-5PM/ Some Holiday's and Weekends Required
In office
Billing Specialist
Position Summary
The Billing Specialist is responsible for ensuring accurate patient registration and insurance information, supporting revenue cycle operations, and reducing claim denials through auditing, education, and collaboration with internal and external stakeholders. This role serves as a key resource for registration staff by reviewing work quality, providing feedback, and facilitating insurance corrections to promote clean claim submission and timely reimbursement.
Key Responsibilities
* Audit emergency department (ER) registration documentation to verify the accuracy of patient demographics, insurance coverage, and eligibility information.
* Provide ongoing feedback, coaching, and education to registration staff regarding registration accuracy, insurance verification, and documentation requirements.
* Identify trends and recurring registration errors and recommend process improvements to reduce claim denials and billing delays.
* Investigate and follow up on denied insurance claims, determine root causes, and take corrective action to secure reimbursement.
* Collaborate with patients, insurance companies, registration teams, clinical departments, and other internal stakeholders to obtain, update, and correct demographic and insurance information.
* Ensure insurance information is accurate and up to date in the billing and registration systems.
* Document denial resolutions, registration corrections, and audit findings in accordance with organizational policies.
* Maintain knowledge of payer requirements, insurance regulations, and billing best practices.
* Assist with special projects and revenue cycle initiatives as assigned.
Qualifications
* Education: High School or GED, required.
* Experience: Work experience in medical billing or hospital coding, claims processor- preferably medical claims for an insurance carrier, or Clerical/Billing experience in a medical office, 1 yr experience required.
* Licensure/Certification: Certified Medical Billing/Coding, preferred.
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