Billing Specialist (IN7103 - Endocrinology)

Job Category: Admin Requisition Number: BILLI005196 Duties and Responsibilities Make necessary corrections to patient accounts and third‑party payor encounters to generate claims. Use the appropriate claims format for each payor type and transmit electronic claims daily; mail paper claims when electronic submission is not possible. Process re‑bills accurately and on a timely basis. Correct re‑bills according to denial codes; review encounters and charts as needed; and conduct research to ensure claims are processed correctly. Complete re‑bills within filing deadlines. Continuously review and monitor accounts receivable aging reports. Record third‑party payments, disallowances, and adjustments in patient accounts via the patient account software. Identify denials and recoupments; reconcile posted amounts with remittance reports and ensure posting is completed by the pre‑determined monthly closing date. Verify third‑party benefit coverage, including co‑pays, deductibles, and co‑insurance. Send patient statements for past‑due balances and apply unapplied credit balances to outstanding balances. Make payment plan arrangements with patients for past‑due balances and monitor delinquent accounts and appointments for habitual non‑paying patients. Provide excellent internal and external customer service via telephone, email, or face‑to‑face contact to assist patients with their health‑care needs. Communicate with clients, support staff, and third‑party payors to address billing questions and concerns regarding charges, payments, adjustments, benefits, and possible refunds. Train and mentor billing staff members in claims processing, entry of individual plans, insurance verification, and other billing office duties. Serve as back‑up for the departmental manager and field questions in the manager’s absence. Complete special projects as needed, such as assisting with the groundwork for electronic billing, completing special reports, and resolving problems. Perform other related duties as assigned. Job Qualifications High school diploma or equivalent. Two years of experience in billing and collecting third‑party health insurance. Knowledge of ICD‑9‑CM and CPT codes and medical terminology. Extensive knowledge of computerized billing systems. Proficiency in Microsoft Word, Excel, and Outlook. Bilingual in English and Spanish preferred. Scheduled hours and/or work locations are subject to change. Physical Activities and Requirements Finger Dexterity – using fingers for small movements such as typing. Talking – frequently conveying detailed or important instructions accurately and clearly. Hearing – able to hear average or normal conversations and receive ordinary information. Repetitive Motions – frequently and regularly using the wrists, hands, and fingers. Visual – average visual acuity necessary to prepare or inspect documents or other materials. Physical – limited physical effort required; may have to lift items weighing up to approximately 25 lbs. Equal Opportunity Employer This employer is required to notify all applicants of their rights pursuant to federal employment laws. For further information, please review the Know Your Rights notice from the Department of Labor. #J-18808-Ljbffr CommuniCare Health Centers (Texas)