What are the responsibilities and job description for the Corporate Billing Specialist position at Cohesive Healthcare Management?
Job Description
Job Description
Description : Position Summary :
A Corporate Billing Specialist plays a crucial role in ensuring accurate and timely billing processes within a corporate environment. This role involves working closely with various departments and clients to generate invoices, track payments, and resolve billing discrepancies. The specialist is responsible for maintaining a high level of financial accuracy and integrity while promoting positive client relations.
Responsibilities
- Prepare and submit billing to assigned payors / insurance companies
- Prepare deposits; distribute / post payments for assigned payors / insurance companies
- Follow up on billing questions for clients as well as clinical staff
- Follow up on outstanding balances with assigned payors / insurance companies
- Maintain payment status and billing records
- Track and resolve billing discrepancies
- Flag write-off recommendations for assigned payors / insurance companies
- Prepare client billing statements, review for accuracy and ensure that they are sent in a timely manner
- Gather, analyze, and respond to member and provider appeals, ensuring compliance with standards
- Maintains a caseload and monitors day to day compliance of appeal decision time frames
- Responds to member, provider, and client telephone inquiries regarding status, process and outcome of appeals
- Coordinates and distributes first, second and third level appeal request assignments
- Consults with managers on problem cases and interfaces with case managers, clinical supervisors, account managers and other personnel in resolving denial and appeal questions
- Provide accurate and timely responses to appeals, grievances and all other correspondence
- Responsible for ensuring all determination responses are compliant with all established regulations
- Communicate effectively with individuals / teams to ensure high quality and timely expedition of customer requests
- Assist Customer Service in responding to and resolving customer questions and concerns related to correspondence
Requirements :
Education / Experience :
Physical Demands and Work Environment
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions. While performing the duties of this position, the employee is regularly required to work inside a clean, well-lit work environment. While performing the duties of this position, the incumbent is regularly required to talk or hear. The employee frequently is required to use hands or finger, handle, or feel objects, or controls. The employee is occasionally required to stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl. The employee must occasionally lift and / or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, color vision, peripheral vision and the ability to adjust focus. The noise level in the work environment is usually moderate. The employee may be required to travel to various locations.
