Billing Specialist
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Job Description
Remote Billing Specialist II submitting compliant medical claims and resolving billing rejections. Supporting Savista’s healthcare clients with revenue-cycle improvement services.
Responsibilities:
- Utilize hospital/physician systems to verify patient, billing and claim information for accuracy
- Perform compliant primary/secondary, tertiary and rebill billing functions through electronic, paper and portal submission to payers
- Edit claims to satisfy billing compliance guidelines for electronic and hardcopy submission
- Respond to emails and telephone messages
- Communicate payer, system and escalated account issues to management
- Attend meetings, training seminars and in-services
- Adhere to professional standards, hospital policies and procedures, federal, state and local requirements, and JCAHO standards
- Update patient demographics and insurance information
- Monitor claims for missing information, authorization and control numbers
- Follow prioritization, timely filing deadlines and notation protocols
- Secure medical documentation requested by third-party insurance carriers
- Maintain confidentiality of patient information
- Use provider billing manuals to obtain billing guidelines and requirements
- Verify and escalate import/export files
- Handle interim bills, overlap review and redistribution of money for correct claim creation
- Research and resolve billing rejections
Requirements:
- 2+ years of medical collections/billing experience
- Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
- Intermediate knowledge of third-party billing guidelines
- Intermediate knowledge of billing claim forms (UB04/1500)
- Intermediate knowledge of payor contracts
- Working Knowledge of Microsoft Word and Excel
- Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
- Preferred: Working knowledge of one or more of EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon
- Preferred: Working knowledge of DDE Medicare claim system
- Preferred: Knowledge of government rules and regulations
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