Billing Specialist

Job Description

Job Description

Work Location: Onsite ONLY in Teays Valley, West Virginia

Physical Requirements:

The employee is regularly required to talk, hear, and sit. Repetitive arm, hand, and finger movements are regularly required. The employee is frequently required to stand, walk, stoop, and reach. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include; close vision, color vision, and the ability to adjust focus.

Qualifications:

High School graduate or equivalent. Excellent customer service, telephone, and computer skills. Knowledge of medical coding and medical billing.

Basic Function:

Responsible for generating third party and patient billing, compiling statistical reports, posting payments, and other duties in the Billing Department.

Duties and Responsibilities:

• Review data provided by providers for accuracy and make edits prior to claim generation.
• Review insurance information and any payer specific requirements (authorizations, modifiers, correct claim form, etc.) prior to claim submission.
• Submit claims electronically to all appropriate payers.
• Work directly with insurance companies, healthcare providers, and patients in reference to claim and reimbursement issues.
• Review, investigate, and resolve claim denials.
• Work on various payer websites.
• Verify patient insurance eligibility.
• Payment posting and batch maintenance.
• Assist patients with account questions.
• Audit, confirm, and submit all documentation for refunds (payer/patient).
• Work assigned weekly/monthly in-box reports in a timely manner.
• Work Aging reports as assigned.
• All other duties as assigned.