Job Description

Description

We are looking for a dependable, dedicated, and respectful person to join our team of Billing Specialists. Outstanding compensation including generous paid time off, 9 paid holidays, excellent health benefits, a company paid pension, multiple bonuses, and more!

POSITION DESCRIPTION:

The Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients and works rejections.

DUTIES AND RESPONSIBILITIES:

* Submits claims to payers based on review of medical records and in accordance with Medicare, Medicaid, and Commercial insurance guidelines as well as FHCSWF policies and procedures.

* Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information to ensure clean claim submission.

* Enters charges accurately and expeditiously to ensure proper records handling and fast payment.

* Timely filing of insurance claims to clearinghouse or individual insurance companies electronically or via paper.

* Review and correction of claim edits within 24 hours of being received from clearinghouse and internal claims scrubber.

* Initiates private pay collections after insurance cancellation, denial or other issue and answer patient questions on patient responsible portions, copays, deductibles, write-offs, etc.

* Performs self-pay patient billing.

* Prepares and sends patient statements for charges not covered by insurance.

* Other duties as assigned.

Requirements

KNOWLEDGE:

* Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment

* Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage

* Understanding of FQHC billing procedures and Sliding Fee Schedules a plus

* EHR systems expertise, preferably with Intergy or other ambulatory care facility-based system

* Understand and adhere to all HIPAA guidelines

* MS Office Suite (Excel proficiency)

* Alpha-Numeric data entry

SKILLS AND ABILITIES:

* High School or Equivalent (Associates Degree preferred)

* 2 Years Medical Billing experience

* CMRS, CPB, or CPC credentials a plus

* Attention to detail with strong documentation, analytic and problem-solving skills

* Ability to multi-task in a fast-paced environment

* Strong interpersonal written & verbal communication skill

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