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About the Role
The Billing Specialist is a member of the Billing Team within the Finance Department, responsible for bill file routing, uploading, error correction, and re-submission.
Responsibilities
- Submit and receive all electronic claim files and payer response/rejection files.
- Research and re-submit claims rejected by clearing house/payer.
- Work pre-post reports prior to submission to ensure claims are correct.
- Initiate and complete enrollment process for payers/providers in medical clearing house.
- Assist in adding and maintaining the HCHB payer setup process.
- Support, maintain, and administer multiple data systems for commercial insurances.
- Perform daily mapping, testing, processing, monitoring, logistics/order processing support, and reporting.
- Collaborate with manager and Billing Team to complete billing claim workflows.
- Use appropriate documentation, reference materials, and/or websites to ensure accurate and efficient billing claim processing.
- Monitor claim rejection numbers and types; resolve and report issues to Revenue Cycle Manager.
- Assist in the development of a Billing Manual.
- Produce high quality, complete, and accurate work.
- Perform other duties as assigned.
Requirements
- Three to five (3-5) years of healthcare-related experience in billing, claims submission, or a prior IT role.
- Team player mentality.
- Ability to work independently.
- Ability to organize, multi-task, and prioritize workload effectively.
- Strong computer and communication skills.
- Understanding of HCPCS, ICD-10, and procedure codes.
- Demonstrated ability to maintain and protect confidentiality.
- Ability to read medical electronic claim file segments and loops.
- MS Office experience, especially Excel (2010+).
- Knowledge and understanding of Explanation of Benefits (EOB).
Skills
- Billing
- Claims Submission
- IT
- Computer Skills
- Communication Skills
- HCPCS
- ICD-10
- Procedure Codes
- Confidentiality
- Medical Electronic Claim File Segments and Loops
- MS Office
- Excel
- Explanation of Benefits (EOB)
Work Type
- Office Setting
Experience Level
- 3-5 years
Education Level
- High School diploma or GED
- Associate's degree preferred
About the Company
- The working conditions are classified as light work: Exerting up to 20 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Light work involves sitting most of the time.
Equal Opportunity
- EOE/AA Minority / Female / Disability / Veteran