Insurance Billing Specialist, Onsite
We are currently looking for experienced Insurance Billing Specialist!
Must be willing to reasonably commute to Hopedale IL, this is not a remote position.
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Obtain accurate, ethical, and optimal reimbursement for hospital and hospital-based services, initiate follow-up of past due balances, handle all components of claims processing including management of disputed, rejected, and delayed claims. Develop a thorough understanding of third-party reimbursement requirements. Enter and electronically or hard copy submit billing data, as necessary. Know and understand all policies and procedures of Insurance Billing. Must be a problem solver, have organizational skills, attention to detail, excellent telephone technique and rapport, and computer knowledge.
Responsibilities:
1 Insurance Claim Billing
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Reviews patient accounts and verifies data for correct billable services and fees. Ensures all pertinent billing information is documented to produce a clean UB-04 claim.
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Runs daily insurance billing reports and reviews discrepancies. Corrects accounts, as necessary.
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Generated Medicare, Medicaid, and Commercial Insurance claims via electronic and hard copy processes.
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Prior to submission, reviews each claim for accuracy and missing information. Transmits claims electronically to TruBridge.
2 Insurance Claim Follow up
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Follow up on any unpaid claim.
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Follow-up on insurance denials and takes appropriate steps to resolve discrepancies.
- Communicates discrepancies and the need for additional information to the appropriate parties. Obtain supporting documentation to appeal claim payment.
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All collection and follow-up efforts will be annotated in the CPSI computer System.
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Re-bill accounts as needed.
3 Ensure accurate Insurance Payments are received
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Receive daily incoming payments and prepare for posting. Review explanation of benefits and verify patient information, payer, and date of service for all transactions.
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Audit payments against contract terms.
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Compute contractual allowances as needed.
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Non-collectible accounts will be forwarded to the Revenue Cycle Director as soon it is determined they are non-collectible with supporting documentation to be written off.
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Assists patients and insurance companies with questions regarding billing procedures, charges, insurance reimbursement, copies of itemized statements, split billings, payments in office, etc.
4 Accounts Receivable Management
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Monitor and maintain assigned Accounts Receivable at minimal levels.
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All assigned accounts are regularly worked and followed up on.
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Ensure any credit balances are resolved and generate refund requests for over payment as soon as possible.
5 Other Duties as Assigned
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Keep updated on all third-party billing requirements. Serves as a resource person for staff inquiries regarding billing issues.
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Assists with training of staff as necessary.
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Other duties as assigned.
Knowledge/Skill/Ability Requirements:
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Minimum of High School Diploma. Some college preferred.
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Knowledge of Medicare Part A, Medicaid, and Insurance Procedures.
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Knowledge of medical billing /collection procedures.
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Prefer 1-2 years in medical business office including Insurance Claim follow up.
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Demonstrated working knowledge of a computerized medical information management system.
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Skills in Microsoft Office Suite (Word, Excel, Outlook).
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Good verbal and written communication skills required.
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Ability to work independently with only general supervision.
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Great attention to detail required along with a high level of dependability.
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Excellent telephone techniques and rapport.
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Ability to effectively communicate and interact with colleagues, hospital staff, patients, physicians and their staff, and third-party insurance personnel.
