Billing Specialist

This is a fully remote position, open to applicants in United States.

📋 Description

• Utilize hospital and physician systems to confirm the accuracy of patient, billing, and claim details.

• Execute compliant primary, secondary, tertiary, and rebill billing processes through electronic, paper, and portal submissions to payers.

• Edit claims to meet billing compliance standards for both electronic and hardcopy submissions.

• Respond to emails and phone inquiries.

• Relay payer, system, and escalated account concerns to management.

• Participate in meetings, training sessions, and in-service events.

• Comply with professional standards, hospital policies and procedures, as well as federal, state, and local regulations, including JCAHO standards.

• Update patient demographic and insurance details.

• Monitor claims for any missing information, authorization, and control numbers.

• Adhere to prioritization, timely filing deadlines, and documentation protocols.

• Secure medical documentation requested by third-party insurance providers.

• Maintain the confidentiality of patient information.

• Utilize provider billing manuals to access billing guidelines and requirements.

• Verify and escalate import/export files as necessary.

• Manage interim bills, overlap reviews, and the redistribution of funds for accurate claim creation.

• Investigate and resolve issues related to billing rejections.

⛳️ Requirements

• A minimum of 2 years of experience in medical collections and billing.

• Intermediate understanding of ICD-10, CPT, HCPCS, and NCCI coding.

• Intermediate familiarity with third-party billing guidelines.

• Intermediate knowledge of billing claim forms (UB04/1500).

• Intermediate understanding of payer contracts.

• Proficient in Microsoft Word and Excel.

• Intermediate working knowledge of health information systems (e.g., EMR, Claim Scrubbers, Patient Accounting Systems, etc.).

• Preferred: Familiarity with one or more systems such as EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.

• Preferred: Working knowledge of the DDE Medicare claim system.

• Preferred: Awareness of government rules and regulations.

🏝️ Benefits

• Comprehensive health insurance coverage.

• Retirement savings plan with employer contributions.

• Paid time off and holidays.

• Opportunities for professional development and training.

• Supportive work environment fostering collaboration and growth.