SUMMARY: This position will be responsible for all phases of the patient billing and for the filing of insurance claims including Medicaid, Medicare, Workman’s Compensation, Disability and multiple third-party commercial insurance companies. The Billing Specialist is responsible for denial follow-ups, payment posting, patient account complaints, insurance billing and accounts receivable inquiries.
ESSENTIAL DUTIES AND RESPONSIBILITIES: Includes the following, other duties may be assigned
• Maintains an up-to-date knowledge of any changes in insurance filing procedures and coverage limitation of the major carriers;
• Responsible for the bad debt patient billing on a monthly basis; patient account statements processed weekly.
• Maintains a system of pending claims and paid out claims in order to have access to the total amount outstanding on insurance and a record of what has been paid;
• Claims should be handled on an ongoing basis and all claims from one week should be filed by the end of that week;
• Enforces the use of collection and billing policies and procedures by making collection calls daily and keeping a log.
• Identify problem accounts and escalate as needed.
• Verifies encounter for charges, disallowance of sliding fee and balances;
• Counsels with patients pertaining to insurance payment, outstanding bills, etc;
• Confers with insurance companies and monitors delinquent claims that are more than 30 days old that have already been filed but are outstanding.
• Ensures all claims are submitted with a goal of zero errors
• Verifies completeness and accuracy of all claims prior to submission;
• Performs other duties and responsibilities as assigned to meet financial goals and requirements of the organization.

