Job Posting OPEN
Billing Specialist
Billing Specialist
The Billing Specialist is responsible for
processing claims for all clients, identifying and resolving claims issues
adversely impacting the revenue cycle management process and achieving
resolution through coordination, reconciliation, and denied claim management.
In addition, follow internal and external policies and procedures to ensure
accurate revenue is booked by monitoring payments, fee schedule changes, health
plan reimbursement changes and any other aspects that impact revenue, cash
collections and adjustments.
Essential
Job Functions:
- Properly codes services,
procedures, diagnoses, and treatments
- Prepares and sends invoices or
claims for payment or reimbursement
- Corrects rejected claims and
ensures accuracy
- Track payments
- Follows up with patients and
insurance companies about outstanding invoices
- Ensures accuracy
- Medical coding and generating
claims in Athena
- Following up on
completed claims, EOBs and verifying posting of claims
- Follow up on denials and
correcting claims if down-coded
- Addressing claims placed
in various hold categories by Athena staff
Qualifications:
Minimum Qualifications:
- High school diploma or equivalent
- Has a minimum of 3 years of Athena medical
billing Experience with CPT and ICD-9/10; Familiarity with medical
terminology Knowledge of billing procedures and collection techniques in
Primary Care
- Adhering to company standards of compliance
with policies and procedures
- Strong written and verbal
communication skills Detail-oriented with the ability to work
independently and prioritize workload Efficient and accurate charge entry
and coding
- Effective organization and multitasking
skills are essential Microsoft Office experience Strong Microsoft Excel
experience
- Possess a thorough understanding
of billing codes, AHCCCS, and have worked closely with insurance claims
representatives in resolving claim issues
- Knowledgeable in AHCCCS, Medicaid,
CMS guidelines and coding policies, RCM compliance and goals.
- Understanding of current coding and billing regulations
and compliance requirements.
- Computer skills- EMR and MS Office (Excel, Word,
Outlook) to write and update notes and generate reports
- Strong analytical and problem-solving skills
- Excellent Interpersonal
- Strong attention to detail
Preferred Qualifications:
- Coding certificate
- Bachelor's degree
Physical
Requirements
o
Prolonged
periods sitting at a desk and working on a computer.
o
Must be
able to lift up to 15 pounds at a time.
Work
Environment:
- Typical office environment.
- This role routinely uses standard
office equipment such as computers, phones, and photocopiers.
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