Specialist, Billing

Job description

General Requirements/Job Duties: To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The requirements listed below are representative of the knowledge, skill, and / or ability required: Billing: Responsible for the evaluation, coordination, development and implementation of billing and related processes. Processes electronic and paper claims in a timely and accurate manner. Ensures edits to electronic claims meet and satisfy billing compliance guidelines for electronic submission. Resolves clearinghouse and DDE claim errors and payer rejections. Performs follow-up processes on underpaid or unpaid insurance claims. Researches, identifies and rectifies any circumstances affecting delayed payment of accounts and takes steps to get claim paid utilizing websites, phone calls to the payers, and/or internal inquiry. Resolves issues holding up timely claim payment, including requests for medical records, coordination of benefit issues, and request for more information, by coordinating with the responsible department. R...