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|Hours:||40 (8 am-5 pm; occ wkds)|
The Billing Specialist answers patient inquiries and handles all correspondence and questionnaires from patients; performs billing that optimizes cash returns; demonstrates sound working knowledge of government regulations and other insurers requirements; identifies claims which cannot be transmitted and requests paper claims; obtains and keys information which is a prerequisite to claim filing; establishes a daily routine from the work queue to track pending eligibilities and unpaid claims; responds appropriately to necessary changes by staying up-to-date on payer requirements and system capabilities; assists Manager/Supervisor in defining new requirements, suggesting solutions and testing additional systems, and identifies delays, inefficiencies and errors.
Primary Job Duties:
- Answers patient inquiries, both clinic and hospital accounts, and obtains Medicare secondary payer information. Handles all correspondence and questionnaires from patients.
- Performs billing that optimizes cash returns and minimizes denied charges, follows guidelines in a sensitive, yet assertive manner when assisting patients.
- Demonstrates sound working knowledge of government regulations and other insurer’s requirements in production of both paper and computer transmitted claims to all payers.
- Identifies claims which cannot be transmitted and requests paper claims from the system and edits, corrects and batches forms for mailing and/or electronic transmissions.
Obtains and keys information which is a prerequisite to claim filing, makes any needed edit changes to the primary payer designation and completes these procedures prior to the release of any applicable holds, and reviews appropriate accounts to be placed on hold.
- Works coverage update work queues or retro adjudication work queues appropriately on a daily basis.
- Works daily work queue of accounts on hold and completes combined accounts, provider based and inpatient hospital claims.
- Responds appropriately to necessary changes by staying up-to-date on payer requirements and system capabilities through insurance bulletins by working and editing accounts.
- Assists Manager/Supervisor in defining new requirements, suggesting solutions and testing additional systems or enhancements.
- Identifies delays, inefficiencies and errors which delay the claims process and solves them independently if possible or reports to Manager/Supervisor.
• One (1) year degree from a business or technical school with an emphasis in business or equivalent education/work experiences.
• Possesses customer service and problem solving skills.
• Computer experience and knowledge of various computer software.
• Demonstrated ability in managing relationships with multiple departments and employees.
• CPT/HCPCS/ICD-9 coding knowledge.
• Knowledge of medical terminology.
• Previous experience with filing insurance claims.
External Applicants Click Here To Apply Online
Current Altru Health System Employees ONLY Click Here To Complete Internal Job Transfer Form