Billing Specialist

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

📋 Description

• Leverage various hospital and physician systems to confirm the accuracy of patient, billing, and claim information.

• Execute compliant billing functions for primary, secondary, tertiary, and rebill claims, including submissions via electronic, paper, and portal methods to payers.

• Modify claims to comply with billing guidelines for both electronic and hardcopy submissions.

• Respond promptly to emails and phone inquiries.

• Report issues to management, including those related to payers, systems, or accounts requiring escalation.

• Engage in meetings, training sessions, and in-services to enhance job knowledge.

• 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 in relevant systems.

• Monitor claims for any missing information, authorizations, and control numbers (ICN/DCN).

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

• Obtain medical documentation required or requested by third-party insurance providers.

• Uphold the confidentiality of patient information in line with insurance collection regulations and corporate policies and procedures.

• Perform additional related duties as necessary.

⛳️ Requirements

• 1-2 years of experience in medical collections or billing.

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

• Basic comprehension of third-party billing regulations.

• Familiarity with billing claim forms (UB04/1500).

• Basic knowledge of payer contracts.

• Proficient in Microsoft Word and Excel.

• Basic working knowledge of health information systems (such as EMR, Claim Scrubbers, Patient Accounting Systems, etc.).

• Familiarity with one or more of the following patient accounting systems: EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon.

• Knowledge of the DDE Medicare claim system.

🏝️ Benefits

• Comprehensive health, dental, and vision insurance.

• Retirement plan options with company matching.

• Paid time off and holiday pay.

• Opportunities for professional development and training.