Billing Specialist

📋 Description

• Processes, edits, audits, and enters service entries into the Electronic Health Record (EHR).

• Generates accurate claims, invoices, and patient bills for services rendered to all patients in accordance with third-party payer guidelines.

• Monitors and collects outstanding accounts receivable while conducting investigations and follow-ups on open balances.

• Reviews Explanation of Benefits and Remittance Advices to ensure accurate payments, copayments, deductibles, and denials.

• Tracks, analyzes, and reports monthly to the director regarding the composition of outstanding accounts receivable, assessing collectability and identifying internal and external issues related to payment receipt.

• Participates in monthly closings, providing necessary data and analysis for all payers.

• Communicates with the utilization review department regarding authorization issues and inquiries.

• Completes essential processes for adjustments, write-offs, charity care, and refunds.

• Contacts Patient Benefit Coordinators, outpatient administrative support staff, therapists, and insurance companies to resolve issues related to funding sources or patient services.

• Maintains interdepartmental reports concerning patient accounts and collections.

• Communicates with third-party Collection Management Companies and patients regarding self-pay balances or billing inquiries.

• Assists in fiscal year audits.

• Coordinates with the Medical Records department for necessary data related to patient appeals and denials.

• Engages in special projects as required.

• Attends mandatory Gateway training sessions and in-services.

⛳️ Requirements

• High School diploma or equivalent is mandatory.

• At least one year of billing experience is required.

• Must pass a Pennsylvania Criminal Background Check.

• Should obtain Pennsylvania Child Abuse and FBI Fingerprinting Clearances.

• Must pass a drug screening test.

• Completion of a 2-Step TB Test is necessary.

🏝️ Benefits

• Favorable working conditions.

• Minimal physical demands.