Billing Specialist
Summary
Processes medical billing for a healthcare provider, submitting claims to insurers and handling patient payments using ICD-10, CPT, and HCPCS codes.
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.