Billing Specialist - Medical Biller

Job Description

Job Description

Overview

The Billing Specialist is responsible for supporting the organization's revenue cycle, with a primary focus on managing accounts receivable for Medicare Part B, Medicaid, and other third-party insurance payers. This includes monitoring aging reports, following up on unpaid and underpaid claims, resolving denials and rejections, and submitting appeals and corrected claims. The Billing Specialist also supports claim submission and ensures required documentation, billing data, payments, and financial records are processed in accordance with company policies, payer requirements, and applicable State and Federal regulations.

Responsibilities

• Responsible for monthly Medicaid, Medicare Part B, and other insurance billings along with timely follow-up with intermediaries and commercial insurance carriers on delinquent payments
• Obtains and submits all required documentation to bill third party payers as per program/company guidelines
• Inputs any ancillary and charge data into the billing system and/or Excel spreadsheets timely and accurately
• Works with or support Revenue Cycle Team in planning all aspects of Business & Billing Office functions to include interfacing with all other disciplines and departments
• May assist the Revenue Cycle Team in monitoring day-to-day operation of the Business & Billing Office and to establish priorities, manage records, budgets, or supplies
• Fills in as Revenue Cycle Manager, as needed with limited or full authority, as given by the COO/CFO
• Supports and assists Revenue Cycle Team with State, Federal and Company standards, to include alerting management to potential non-compliance issues and the preparation of correction plans
• Assists with end of month close procedures such as, but not limited to charge input, cash receipts reconciliation
• Maintains accuracy and efficiency in all work performed
• Prepares disbursement checks for payment of expenditures approved by COO/CFO
• Assists with filing and storage processes/systems as needed
• Assists with company information tracking and reports as needed
• Other special projects and duties, as assigned

Qualifications

• High school diploma required and equivalent related work experience
• Minimum of one (1) year billing and/or coding experience preferred
• Effective verbal and written English communication skills
• Demonstrate intermediate to advanced skills in Microsoft Word, Excel, Power Point and Outlook, Internet and Intranet navigation
• Highest level of professionalism with the ability to maintain confidentiality
• Ability to communicate at all levels of organization and work well within a team environment in support of company objectives
• Customer service oriented with the ability to work well under pressure
• Strong attention to detail and accuracy, excellent organizational skills with ability to prioritize, coordinate and simultaneously maintain multiple projects with high level of quality and productivity
• Strong analytical and problem-solving skills
• Ability to work with minimal supervision, take initiative and make independent decisions
• Ability to deal with new tasks without the benefit of written procedures
• Approachable, flexible, and adaptable to change