Billing Specialist

Title of Position: Billing Specialist

Nature of Position: The billing specialist will be responsible for working with the team to ensure that

claims are processed promptly and efficiently.

II. Responsible to: Director of Revenue Cycle

III. Responsibilities:

• Data Management Specialist
• Checking eligibility and benefits verification for office procedures.
• I'm looking over the patient bills for accuracy and completeness, and obtaining any missing information.
• Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
• Encounter Review of charts to ensure codes/charges are accurate.
• Working daily schedules from offices to ensure all charges are captured.
• Following up on unpaid claims within the standard billing cycle timeframe.
• Checking each insurance payment for accuracy and compliance with contract discount.
• Calling insurance companies regarding any discrepancy in payments if necessary
• Identifying and billing secondary or tertiary insurances.
• Reviewing accounts for insurance of patient follow-up.
• Claim Denial Management: refiling, researching, and appealing denied claims.
• Answer all patient or insurance telephone questions about assigned accounts.
• Setting up patient payment plans and work collection accounts.
• Updating cash spreadsheets, and running collection reports.
• Posting all insurance payments received, as assigned.
• Working with sites to ensure that payments are posted daily and information is accurate
• Daily posting and balancing, as assigned
• Auditing Sliding Fee Scale (SFS) applications for all medical sites. Ensures applications are complete and the front desk staff has collected proper documentation.
• Become an SFS subject matter expert to handle all SFS questions/issues.
• Ensures SFS is properly entered into EHR
• Works with Site Leads on any errors identified
• Follow up on errors to make sure corrections have been made
• Works with the Billing Team to ensure claims have slid correctly after corrections are made
• Assist the Billing Team with special projects as needed
• Once SFS claims are caught up, assist the front desk with identifying patients with expiring slides.
• Other duties as assigned