Now Hiring: Billing Specialist
Location: This position is remote. In order to attend in person meetings from time to time, an ideal candidate would live within a resonable drive to Franklin, TN or Providence, RI.
Hours: Monday - Friday, 40 hours a week
Our Benefits:
- Comprehensive Medical, Dental, & Vision insurance
- Competitive 401(k) retirement plan
- Generous PTO: Paid vacation, personal time, sick Leave, and extended sick Leave
- Career advancement opportunities across a leading national network
Your Job as a Billing Specialist:
The Billing Specialist is responsible for daily accounts receivable data entry and billing. To assist with increasing collections, reducing accounts receivable days, and reducing bad debt.
Job Responsibilities:
- Responsible for the timely verification of insurance benefits provided via websites and/or calling the payor.
- Responsible for updating patient Billing Episodes and crediting account, as appropriate.
- Obtain precertification and authorizations for services being rendered
- Review and resolves prior authorization/precertification/referral issues that are not valid and contacts insurance carriers to verify/validate requirements to ensure accuracy and avoid potential denial.
- Validates all necessary referrals/prior authorizations/pre-certifications for scheduled services are on file and shared with all appropriate staff and are valid for the scheduled services performed.
- Ensure all account activity is documented in the appropriate system and shared with all appropriate staff timely and thoroughly.
- Clinic Emails – responsible for managing clinic emails throughout the day (i.e., re-verification requests, balance inquiry, etc.). All clinic emails must be responded to by close of business daily.
- Identify and forward potential reimbursement problems to Revenue Cycle Manager.
- Proactively interacts with Clinics and other appropriate staff sharing benefits, authorizations and eligibility.
- Responsible for billing all patient claims in a timely manner (weekly billing, secondary and out-of-network plans).
- Review claims issues make corrections as needed and rebill. Utilize claims clearinghouse to review and correct claims and to resubmit electronically when available.
- Responsible for evaluating bill cycles and changing/updating when necessary.
- Responsible for printing daily billing reports – both electronic and paper claims. Monitor validation percent.
- Work daily claims rejection lists including but not limited to; claims rejected due to auto eligibility process during weekly billing and “Rejected” claims due to eligibility, coordination of care and authorization as part of accounts receivable.
- Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
- Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.