Clinic Billing Specialist
US-KY-Harlan
careers
Req #: 36627
Type: Regular Full-Time
|
|
|||||||||
|
||||||||||
Overview: Under general supervision, the Clinic Billing and Follow-Up Specialist handles essential billing and insurance follow-up functions. This role requires a fundamental understanding of insurance claim processing, knowledge of HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handle denials, and perform follow-up with insurers to ensure claims resolution. The position encompasses business office responsibilities related to patient accounts, including charge import, appeals, diagnostics and procedural coding, and claim follow-up with third-party payers to achieve a zero-balance resolution. Responsibilities: Functions * Promote the mission, vision, and values of the organization * Import charges from queues in a timely manner and append modifiers or any required information for claim transmission * Review daily accounts that are ready to be billed in Waystar from Meditech * Initiate correction on all claims with errors by the designated time * Follow up on any correspondence that may have been received on that day or the previous day * Cross train on billing all lines of business to the different payers * Pull listing of all accounts assigned to be follow up by specific payer * Diagnostic and procedural coding Follow-Up Responsibilities * Responsible for the resubmission of primary, secondary, and tertiary claims per respective regulations and policies. * Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims. * Follow-up daily on post processing activity including but not limited to, rejected billings, adjustments, and rebilling, and denied claims for accounts. * Maintain accounts receivable detail of their accounts through tasking. * Maintains standards per payer for percentage accounts >90 days. * Works minimum standard number of accounts per payer per day. * Meets or exceeds collection goals by payer each month. * Works all assigned accounts as assigned, depending on balance. * Complete appeals as required. * Participates in educational activities and attends monthly department staff meetings. * Maintains confidentiality: adheres to all HIPAA guidelines/regulations. * Other duties as assigned from time to time. * Attend educational activities and monthly department staff meetings * Perform other duties as assigned Qualifications: * High School Diploma or GED * Six months previous experience in clinic registration, billing and collections, financial counseling, or customer service preferred * Knowledge of medical terminology preferred * Basic computer proficiency * Typing speed: minimum 40 WPM * Familiarity with CPT and ICD-9 coding is helpful * Good written and verbal communication skills are essential for account follow-up
Share this job:
