POSITION SUMMARY
The Billing Specialist is responsible for the Revenue Cycle- Charge Entry
ESSENTIAL FUNCTIONS
- Accurately enter patient charges, including CPT/HCPCS codes, ICD-10 diagnosis codes, modifiers, units, providers, locations, and dates of service into the practice management system.
- Review encounter forms, procedure documentation, procedure reports, and other source documents to ensure all billable services are captured accurately and timely.
- Enter and verify injectable drug charges, including HCPCS codes, units, NDC information, administered/discarded quantities, and applicable JW/JZ modifiers.
- Ensure procedures and diagnosis codes are appropriately linked and that laterality and applicable modifiers are accurately entered.
- Reconcile completed patient encounters against charges entered to identify and resolve missing or delayed charges.
- Communicate effectively with, clinical staff, front-office staff, insurance verification, to resolve charge-related questions or discrepancies.
- Maintain established productivity, accuracy, and charge-entry turnaround-time standards.
- Assist with reviewing reports and work queues to ensure outstanding charges are resolved and claims are released timely.
- Follow established Medicare, Medicaid, commercial payer, CPT, HCPCS, ICD-10, NCCI, and practice billing guidelines applicable to assigned responsibilities.
- Protect patient confidentiality and comply with HIPAA, regulatory requirements, and organizational policies.
- Identify recurring charge-entry errors or workflow concerns and communicate them to management to support process improvement and prevent lost or delayed revenue.
REQUIRED SKILLS
Ability to work independently and have strong organizational and time management skills
Strong critical thinking and problem-solving skills
Ability to work under pressure
Dependable
Exercises safe judgment in decision making
Demonstrates tact and understanding when dealing with patients, team members, members of other disciplines, and the public
Must possess honesty, integrity, and accountability
WORK ENVIRONMENT
The Billing Specialist will work primarily remote or in an office setting – limited travel to outside meetings (see TRAVEL).
PHYSICAL DEMANDS
Must be able to move intermittently throughout the workday
Must be able to speak and write the English language in an understandable manner
Requires repetitive hand motion
Minimal lifting and carrying requirements
TRAVEL
Minimal
DIRECT REPORTS
None
REQUIRED EDUCATION/EXPERIENCE
High school diploma or GED
1 – 2 years of medical billing or medical charge entry experience required
PREFERRED EDUCATION/EXPERIENCE
1 – 2 years of medical billing or medical charge entry experience required
CERTIFICATIONS
N/A
*This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required by the employee. Other duties, responsibilities and activities may change or be assigned at any time with or without notice.
Job Type: Full-time
Benefits:
- 401(k)
- Dental insurance
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
- Vision insurance
Work Location: In person
