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Patient Billing Specialist
2 months ago
- 401(k)
- 401(k) matching
- Competitive salary
- Dental insurance
- Health insurance
- Paid time off
Position Summary:
The Patient Account Biller is responsible for the timely and accurate billing of patient accounts. This role ensures that all billing activities comply with applicable regulations. The individual in this position works closely with patients, insurance companies, and healthcare providers to resolve billing issues.
Key Responsibilities:
Billing:
- Prepare and submit accurate claims to insurance companies, government programs, and other third-party payers.
- Review patient accounts to ensure proper billing procedures have been followed and correct any discrepancies.
- Ensure timely submission of claims to maximize reimbursement.
- Monitor and follow up on unpaid claims, identifying and resolving any billing issues or errors.
- Process payments, adjustments, and write-offs according to company policies.
- Reviews Program Memorandums as needed to assure compliant bill practices
- Determine if reimbursement is correct per contractual guidelines.
- Performs problem resolution for front end billing, must understand matrix interpretation systems. Knowledge of contract interpretation skills required.
- Creation and management of follow-up workflow.
- Payer rules and appeal guidelines. Able to interpret and implement Medicare guidelines.
- Stay up to date on healthcare billing regulations and ensure compliance with all applicable laws and guidelines.
- Assist in preparing reports on billing and collection activities for management review.
- Participate in audits and quality assurance activities as needed.
Education:
- High school diploma or GED required, Associate's degree in healthcare administration, business, or a related field preferred.
- Minimum of 2 years of experience in physician, hospital or third-party billing, collections, or a related field.
- Extensive experience with insurance claim processing and patient billing procedures.
- Knowledge of databases to obtain eligibility information.
- Familiarity working with Electronic Health Record (EHR) systems and billing software.
- Experience in appeals, denials, underpayments, UB92 and 1500 forms.
- Strong understanding of medical billing codes (CPT, ICD-10) and insurance reimbursement processes.
- Excellent communication and interpersonal skills, with the ability to handle sensitive and confidential information.
- Strong organizational skills and attention to detail.
- Ability to work independently and as part of a team in a fast-paced environment.
- Proficient in Microsoft Office Suite (Word, Excel, Outlook).
- Knowledge of Tebra Software preferred but not required
- Knowledge of federal and state healthcare billing regulations, including HIPAA.
- Understanding of Chronic Care Management (CCM) and Provider Psychiatric billing.
- May require occasional evening or weekend work to meet deadlines or handle urgent issues.
- Requires sitting for long periods and using office equipment, such as computers, phones, and fax machines.
This is a remote position.
