Billing Specialist

Billing Specialist

This is a full‑time, hourly non‑exempt position. The overall goal is accurate charge entry and timely collection of monies due from carriers and patients for medical, dental and behavioral health claims.

• Post encounters as assigned and verify all insurance carriers.
• Audit and chart review in a timely and accurate manner for coding and billing compliance, review all posted encounters for assigned pay codes.
• Make sure assigned codes meet all federal, legal and insurance regulations.
• File secondary claims and follow through.
• Submit all approved tickets electronically to the clearinghouse and retrieve and process reports from them or print them on paper, if necessary.
• Post payments received from third‑party payers manually, or if electronic posting is enabled for payer, review for oddities and make corrections when needed.
• Resubmit denied claims after review and corrections are made.
• Run aging detail and old claims for payment status and correct as necessary monthly.
• Ensure all measures are exhausted to collect from insurance carrier before claim is submitted to revenue cycle manager for approval to write off.
• Inform the manager of any issues that arise.
• Provide training for the front desk staff on insurance carriers on an as‑needed basis.
• Assist providers or procedure entry staff with coding for encounters and/or hospital billing.
• Monitor regulatory changes pertaining to Medicare, Medicaid, and commercial insurance.
• Credentialing duties as assigned providers with all insurance carriers.
• Work on special billing/financial projects and train new employees as requested.
• Attend billing seminars and workshops as needed.
• Working knowledge of ICD‑10, current procedural coding.
• Other duties as assigned.

• Excellent communication skills; active listening and written and oral comprehension/communication; give full attention to what individuals are saying, understand the point being made, ask appropriate questions to gain better knowledge of situations and repeat information to ensure understanding; public speaking skills necessary; bilingual (English/Spanish) language skills helpful.
• Excellent customer service skills actively seek ways to assist internal and external customers within the scope of assigned duties.
• Good basic mathematical skills use a calculator or other means to accurately assist in financial matters.
• Good computer skills;
  Outlook, Windows, Microsoft Office, Excel applications.
• Good time management skills self‑evaluate the use of time and understand how others may be affected.
• Cultural diversity awareness and skills; respects all people regardless of race, nationality or social standing.
• Ability to work independently (self‑motivating) and as a team member.
• Ability to develop a collaborative therapeutic alliance with individuals and make accurate professional judgments.
• Ability to build and maintain effective working relationships with co‑workers, providers, managers, patients, agency resource personnel and community members in general.
• Familiarity with local community resources for patients with chronic disease.
• Knowledge of the health and human services infrastructure, health insurance programs and public coverage options.
• Problem sensitivity skills; empathetic/understanding.
• Deductive reasoning and problem‑solving skills.
• Organized and detail‑oriented.
• Familiar with prior authorizations and referrals as needed for claims.

• High school diploma or equivalent (GED) required.
• Degree or certificate in billing/coding preferred.
• Certified in medical and/or dental coding preferred.
• Two years’ experience required.
• Computer knowledge required;
  Windows, Microsoft Office applications and practice management systems.
• Prior experience in professional office environment preferred.

• May sit and/or stand for long periods of time.
• Must be able to see and hear within normal range with or without correction device(s).
• Dexterity and hand‑to‑eye coordination as normally associated with operating office equipment, computers and telephone.

Professional, fast‑paced office environment.