Job Description

Job Description

Job Description

Salary:

POSITION SUMMARY:

**Not a remote position**

The Billing Office Claims Specialist will undertake a variety of financial and non-financial tasks to help guarantee the companys revenues and will be held accountable for the status of insurance claims while identifying inconsistencies in billing procedures, insurance guidelines, and coding standards.

RESPONSIBILITIES:

• Work with Claims team Lead and Administration to correct and educate on any billing, coding, and CPT issues.
• Work assigned insurance category claim issues, refunds, appeals, and records requests.
• Work shared task of rejects/failed claims in the clearinghouse and AM/PM Billing.
• Work shared task of Labcorp letters as received.
• Work claims held for system rules daily.
• Answer phones as backup daily.
• Work shared tasks of voicemails and billing email that are to be checked daily.
• Maintain CPC certification.

KNOWLEDGE, SKILLS, ABILITIES:

• Ability to work independently or as a Team player positively to achieve daily, weekly, and monthly goals.
• Ability to communicate effectively on the telephone with good customer service.
• Ability to relate to persons with diverse educational, socioeconomic, and ethnic backgrounds.
• Ability to exercise good judgement to handle calls appropriately.
• Working knowledge of medical terminology.
• Ability to work under pressure, meet deadlines and manage several tasks simultaneously.
• Ability to maintain professional behavior and promote a positive image of the practice.
• Knowledge of insurance guidelines for the different insurance categories.
• Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
• Ability to handle confidential and sensitive information.

PHYSICAL ENVIRONMENT/REQUIREMENTS:

• Professional medical office setting without significant variation in temperature or lighting.
• Normal working hours are 8:00 AM to 5:00 PM Monday through Friday in office; some incidences of work beyond the normal business hours should be expected based on patient demand.
• Performance of basic physical functions of finger dexterity, grasping, clearly understood speaking, hearing, sight (far and near to include data, figures, and computer equipment), and repetitive motion.
• Performance of primarily sedentary work, sitting for extensive periods of time; occasional lifting or moving of object weighing up to 20 pounds.

EDUCATION/EXPERIENCE:

• Graduation from High School or Equivalency.
• RHIT, CPC, or CPC in progress while working in medical billing office, will consider relevant experience in lieu of CPC.
• A minimum of one to three years of experience in a medical billing office setting.

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