Billing Specialist

Job Details

Job Location: Charlotte NC Office - Charlotte, NC

Position Type: Full Time

Salary Range: Undisclosed

Job Category: Admin - Clerical

Description

The Billing Specialist is responsible for ensuring accurate communications of billing invoices to insurance companies, organizations, and individuals. It is the responsibility of the billing specialist to ensure that all insurance contracts needed for proper billing are in place and current. The billing specialist must maintain current on continuing education regarding billing codes and procedures.

Essential Job Duties

• Review new and current patient insurance information.
• Ensure correct and up to date insurance information is on file through eligibility checks in Brightree software.
• Review Insurance benefits and communicate coverages, deductibles, and coinsurance to Customer Service and General Manager when appropriate.
• Receive shipping confirmations and confirm bill to proper insurance agencies.
• Upon receipt of shipping confirmations, review Sales Order to ensure proper HCPC coding and diagnosis exist to justify accurate billing to insurance company.
• Review Sales Order for accuracy in products HCPC codes as well as HCPC code grouping on certain items
• Ensure span dates are used for appropriate Insurance Agencies.
• Review and post ERN payments in Brightree software.
• Receive confirmation of payment receipt from General Manager and post ERNs accurately to ensure secondary insurance billing and patient account billing.
• Address any denials and non-covered items.
• Communicate with Insurance companies to resolve payment issues related to but not limited to the following
• Insurance payment errors
• Quantity allowed errors
• Diagnosis errors
• Filing errors
• Assist in acquiring and maintaining insurance network contracts.
• Review referrals to determine if the Insurance Agency is new to Donaco Medical.
• Determine what forms are needed for Donaco Medical Supply to properly bill new Insurance Agency
• Assist and advise on becoming in network with new insurance agencies or setting up NPI for proper billing with ERA/ERNs and EFTs.
• Review Existing Insurance Contracts and advise General Manager on inquiring about in network contracting.
• Determine if networks are open or closed
• Research Fee schedules if possible
• Communicate with Brightree and clearing houses regarding contracts to ensure proper billing, fee schedules, and EFTs are in place
• Assist Vice President of Operations
• Determining if Prior Approvals are needed and proper filing
• Responding to Audits from Medicare and Private Insurance Agencies
  

Qualifications

• High level of Analytical Skills.
• Self-Motivated
• Task Management Skills
• Data Entry, Reporting Skills,
• Dependability
• Organization
• Confidentiality
• Independence
• Teamwork
• Microsoft Office Skills
• Brightree Software