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Job Summary: The Billing Specialist will process and follow up on patient billing, review remittance advice forms to verify proper reimbursement, and adjust as necessary. The Billing Specialist will manage account receivables by preparing and submitting claims to insurance carriers and post insurance and patient payments. They will follow up with insurance carriers on unpaid, rejected, or denied claims and answer patient inquiries regarding their account status and charges.

Duties/Responsibilities:

• Enters information necessary for insurance claims such as patient information, insurance identification, diagnosis and treatment codes, modifiers, and provider information.
• Checks to ensure that clinic records for patients include all information required for insurance reimbursement.
• Insures claim information is complete and accurate, including correct insurance coding to ensure prompt payment.
• Inputs correct billing information and submits insurance claims to insurance companies electronically or via paper.
• Prepares and submits secondary claims upon processing by primary insurer as needed.
• Prepares and sends bills to patients for their responsible portion.
• Posts insurance payments and patient payments via electronic posting or manual posting.
• Consults with insurance carriers about any disputed claims and follows up on all bills not processed within usual claim period.
• Reviews any adjustments made to bills as submitted and consults with the insurance office.
• Authorizes or adjusts clinic bills to correct errors.
• Prepares weekly and monthly reports of billing.
• Attends training to keep abreast of changes in insurance billing procedures.
• Follows up with insurance companies on unpaid or rejected claims.
• Communicates with necessary contacts to resolve issues and re-submit claims as needed.
• Answers patients’ questions on patient responsible portions, co-pays, deductibles, write-off’s, etc.
• Resolves patient complaints and/or explains why certain services are not covered.

Required Skills/Abilities:

• Hearing ability to discuss billing with therapy staff, patients, and office staff.
• Basic understanding of clerical and administrative procedures.
• Excellent written and verbal communication skills.
• Excellent organizational and time management skills.
• Ability to solve problems as they arise.
• Proficient in Microsoft Office Suite or similar software.

Qualifications/Education/Experience:

• High school diploma or equivalent required.
• Two years of experience in clerical/office support work desired, but not required.
• Associates degree preferred, but not required.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift up to 15 pounds at times.