What are the responsibilities and job description for the Billing Specialist - Remote position at The Center for Orthopedic and Research E?
Job Description
Job Description
Remote position
ESSENTIAL FUNCTIONS
Maintains productivity and accuracy metrics per department expectations.
Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
Reviews insurance rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding rejections.
Correct and identify billing errors and resubmit claims to insurance carriers.
Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
Assist in identifies and communicating trends and / or potential issues to management team.
Payer website user access maintenance.
Responsible for system maintenance of Athena master files including referring provider information, accurate insurance plan information and payer enrollments.
Responsible for EDI, ERA and EFT enrollments for all payers.
EDUCATION
High school diploma or GED
EXPERIENCE
Minimum two to three years of experience in medical billing. Experienced candidates will have prior experience working claim errors in a claims management system. Prefer candidates with knowledge of ERA / EFT enrollment as well as ANSI formatting.
Knowledge of ICD-10, HCPS, and CPT codes, medical terminology, and billing practices.
Advanced computer knowledge, including Window based programs.
Knowledge of EDI formats; ability to read and interpret ANSI X12 270 / 271, 835 and 837 file formats.
Knowledgeable in both the billing processes utilized and is also knowledgeable with the specific applications that support those processes within the revenue cycle.
SKILLS
Possesses strong organizational skills and careful attention to detail.
Skill in effective data collection and analysis.
Skill in using computer programs and applications.
Must demonstrate quality communication skills, exhibiting a professional and ethical attitude at all times.
Skill in effectively managing multiple projects simultaneously.
ABILITIES
Ability to multitask in a fast-paced environment. Must be detailed oriented with strong organizational skills.
Ability to understand patient demographic information and determine insurance eligibility.
Ability to work independently, and as part of a team.
ENVIRONMENTAL WORKING CONDITIONS
Normal office environment.
PHYSICAL / MENTAL DEMANDS
Requires sitting and standing associated with a normal office environment. Some bending and stretching required. Manual dexterity using a calculator and computer keyboard
ORGANIZATIONAL REQUIREMENTS
HOPCo Mission, Vision and Values must be acknowledged and adhered to
List additional organization requirements such as training conducted by organization
This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.
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