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Billing Specialist
Summary: The Billing Specialist may be required to fulfill key billing aspects including but not limited to: primary and secondary claims per regulations and policies, re-processing of denials of claims, and ensuring billing and coding are accurate and correct.
Essential Duties/Responsibilities:
- Greet and provide assistance, guidance and direction to visitors and clients.
- Responsible for the submission or resubmission of primary, secondary, and tertiary claims per respective regulations and policies.
- Ensures billing and coding are correct prior to sending appeals or reconsiderations to payers.
- Complete insurance verification.
- Investigate un-adjudicated claims and complete appropriate follow-up
- Clearly document issues and resolution.
- Communicate with third-party representatives as necessary to complete claims processing and /or resolve problem claims.
- Maintains confidentiality and adheres to all HIPAA guidelines/regulations.
- Exhibit exceptional customer service skills; answering patient and insurance calls; prompt return and follow up to all interactions; prompt response to requests for information.
Non-Essential Duties/Responsibilities:
- Collaborate with Finance Director to coordinate yearly LifeCare enrollment
- Performs other duties as required.
Required Competencies and Experience:
- Strong understanding of physiology, medical terms and anatomy
- Strong knowledge of medical billing and coding procedures.
- Associate’s degree or higher and/or two years of equivalent experience
- Minimum of 1 years’ experience in any medical billing and coding industry
Physical Requirements:
- Prolonged periods of sitting at a desk and working on a computer.
- Must be able to lift 15 pounds at times.
Working Environment:
- Standard working hours: Monday to Friday, 8:00 AM – 5:00 PM
- Based in a professional office setting
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