The Insurance Billing Specialist is responsible for a range of billing processes related to managing the ready to bill unbilled revenue. This position is responsible for the timely and accurate billing of all patient accounts to meet and/or exceed our departmental goals for cash collections and AR.

Minimum Requirements

Education

• High School Diploma or equivalency

Experience

• Must have had at least 4 years electronic billing and/or billing editing experience in a hospital and/or physician office setting.
• General Knowledge of HCPCS, CPT-4 and ICD9-10 coding and/or medical terminology.
• Familiar with multiple payer requirements and regulations for claims processing
• Solid Microsoft Office skills required.
• Good communication skills and the ability to courteously interact with multiple departments within SRHS

License/Registration/Certifications       

·        N/A

Preferred Requirements

Preferred Education

• Healthcare related Associates or Bachelor’s degree

Preferred Experience

• 5+years billing experience in a hospital and/or physician billing setting.
• Experience in billing both technical and professional charges.
• Experience with DDE

Preferred License/Registration/Certifications   

·        Certified Revenue Cycle Associate (CRCA)

·        Certified Professional Coder- Hospital Services (CPC-H)

Core Job Responsibilities

• Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers.
• Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical billing practices.
• Must possess a good working knowledge of the UB04 and CMS 1500 claim forms and the data elements/field data required
• Responsible to bill all services within timely filing as defined by departmental goals and insurance guidelines.
• Must understand and comply with the rules regarding edits.
• Responsible for all billing related denials to identify trends to improve clean claim rates
• Responsible for multiple daily reporting of billing indicators through various reporting tools
• Must be able to accurately complete review and resolve all combined billing requirements to ensure compliance.
• Responsible to work all referrals within a 24/48-hour turnaround time from receipt.
• Exhibit good professional communication and customer service skills at all times while working with coworkers and employees in multiple departments within the system.

Other duties as assigned

Sr Denials Management Specialist-Remote

Specialist-Collections II (Remote)

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