Billing Review Specialist

Billing Review Specialist

This employee ensures that all assigned reviews and company projects are completed timely and accurately according to the scope of work. They will report any issues and/or concerns timely to the Supervisor of the Centralized Billing Review team and/or Manager of the Centralized Billing Review team.

Job Functions

• Contacts payors at times to discuss policy criteria or to ask clarifying questions on accounts
• Understands payor requirements according to their policies
• Ensures completion of all forms and collects complete billing information
• Pursues, maintains, and communicates medical coverage/guideline changes/updates
• Verifies insurance benefits and eligibility for patients
• Communicates with patients to resolve billing issues and ensures timely payment
• Maintains accurate and up-to-date patient records in compliance with HIPAA regulations
• Works assigned reports accurately and timely
• Helps facilitate interoffice communication on payor updates and trends
• Completes any adjustments/transfers of AR as required
• Documents all activity in customer's computer account or applicable applications
• Answers billing review specialist questions accordingly
• Reports issues and/or concerns in a timely manner
• Available to assist other billing review specialists on the team with questions or needs
• Acts as liaison between staff and management

Education

• High School Diploma or General Education Degree (GED) Required

Knowledge, Skills, and Abilities

• Past performance shows solid evidence of insurance qualifications and guidelines
• Telephone etiquette and adequate oral and written communication
• Shows effective multitasking
• Positive and cooperative attitude in working and communicating with individuals at all levels of the organization
• Medical field experience preferred