Billing Specialist - Charge Entry

Position Summary:  Under direct supervision, is responsible for initiating and coordinating all functions related to submitting and collecting on medical claims.  This includes charge entry, payment posting, claims appeals, cash management and collections.  

Responsibilities:

• Input all charges related to the assigned physician/service into eCW, including office and hospital charges within 24 hours.   Communicate to management if you are behind and not current.  
• Emphasis on accuracy to ensure timely reimbursement.   
• Knowledge of insurance carriers, managed care plans, referral/precertification procedures and order of insurances.  
• Working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines.  
• Knowledge of Incident to Billing.  
• Detailed oriented, must read billing notes and accurately suppress errors.
• Creating WC/NF claims in eCW.  Choosing the correct fee schedule, adding the WC/NF info in data and making sure the claim is to print HCFA status. 
• Properly routing claims, daily HCFA claim submission of primary and secondary payers.
• Working additional scrubs and reports to ensure accuracy. ie EBO Infusion report generated daily of costly drugs to check accuracy on units.  O:Drive Reports IT, Infusion Appointment -  Generated daily to accurately enter modifier 25 on office visit claims w/ same dsy infusion.  
• Daily electronic claims submission through Waystar.
• Daily claims rejected in Waystar must be worked in eCW or forwarded to follow-up after determining what the issue is.
• Waystar administration, which includes adding new providers and managing provider certifications
• Regular communication with management in effort to produce clean claims, fix edits and eliminate errors.  
• Work pending claims with a negative balance.

Other Duties

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

Skills & Experience Necessary: 

• Strong general office skills, including typing skills 
• Strong planning, problem solving and organizational skills 
• Working knowledge of Microsoft windows programs including Excel and Word 
• Working knowledge of general office equipment including multi-line phone, computer, copier, calculator, and fax machines 
• Effective communication and interpersonal skills 
• Medical Terminology 

Required Education 

Preferred Education:

• ·     Associates Degree in Medical Billing and Reimbursement with a minimum of 1 years of Medical Billing experience
• Previous experience in medical practice setting
• Experience with ICD-10 and CPT coding
• Knowledgeable in collection process 

Working Conditions:

• Normal working environment, typical of most office settings 
• Minimal physical effort, requires some lifting of files, usually not in excess of 15 pounds. 
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions