Billing Specialist II - Full-time / Part-time

Billing Specialist II

SUMMARY

Responsible for insurance timely billing and follow up. Handles insurance claims, and performs collections duties. Identifies underpaid claims timely and understands denial code to effectively collect documentation and present effective appeal.

DUTIES AND RESPONSIBILITIES

• Collect and manage accounts
• Effectively manage aging of receivables.
• Review delinquent insurance accounts and calls for collection purposes
• Process payments from insurance companies.
• Maintain strict confidentiality.
• Scans paperwork
• Handle information about patient treatment, diagnosis, and related procedures to ensure proper coding.
• Use computers to read and organize charts.
• Follow up to see if a claim is accepted or denied.
• Investigate rejected claims to see why denial was issued.
• Assists in patient collection letter inquiries and calls.
• Initiate insurance appeals.
• All other duties and responsibilities that may be assigned.

SKILLS DEMONSTRATING PROFICIENCY AT THIS LEVEL

• Locates insurance and patient records and navigate in the billing system.
• Understands physician roles and how they impact payer reimbursements.
• Understands Healthcare Common Procedure Coding (HCPC) codes.
• Understands diagnoses codes.
• Demonstrates ability to manage customer relationships.
• Understands company’s products and services.
• Understands and enforces simple payer contract terms and requirements.
• Demonstrates basic knowledge of medical claims reimbursements (co-pays, deductibles, order of payers, and allowable/adjustments).
• Effectively analyzes and manages payer claims to remittance times.
• Identifies underpaid claims timely and understand denial codes to effectively collect documentation and present effective appeal.
• Knows and uses appropriate modifiers for each payer.
• Manages claims portfolio within insurance appeals timelines.
• Updates master payer records.
• Train level 1 billers.

This is a Temp to hire position, $15-16 per hour