Billing Specialist

Overview

The Billing Specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials, documenting related account activities, posting adjustments and collections of Medicare, Medicaid, Medicaid Managed Care, and commercial insurance payers. The Billing Specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods to correctly record contractual adjustments based on payer contracts or government regulations.

In addition, the Billing Specialist must demonstrate proficiency with billing systems to ensure all functionality is utilized for the utmost efficient processing of both hospital and professional claims and issuing refunds when necessary. Likewise, the Billing Specialist must be willing to assist the Billing Supervisor with departmental training and perform various miscellaneous work assignments.

Shift: M-F, 8:30 AM - 5:00 PM

• Process accurate billing and timely submission of electronic and paper claims.
• Monitor claim status and research rejections and denials.
• Document related account activities and post adjustments.
• Manage collections for Medicare, Medicaid, Medicaid Managed Care, and commercial payers.
• Apply payer contracts and government regulations to record contractual adjustments.
• Utilize billing systems to ensure efficient processing of hospital and professional claims.
• Issue refunds when necessary and assist with departmental training and miscellaneous tasks as needed.

• High School graduate or equivalent required.
• One year or more of on-the-job experience in a like or similar position is required.
• Knowledge of computer and typing skills required.
• Ability to work independently and be detail oriented.
• Knowledge of medical terminology required.
• Must have a good working knowledge of Medicare, Medicaid, and other insurance payors billing guidelines.
• Ability to handle stress in a mature and professional manner; identify problem situations and implement actions for improvements.

• Ability to lift up to 30 pounds; walk, sit, and stand for extended periods.
• Requires use of office equipment such as computer terminals, copiers, fax machines, or microfilm readers.
• Requires normal vision/hearing range, no color blindness; adequate eye-hand coordination and manual dexterity.