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Billing Representative Ii
3 months ago
**Position Summary**:
We have an exciting opportunity to join our team as a Billing Representative II.
Under general direction submits claims. Follows-up on unpaid balances (insurance or patient), corrects errors, enters claim information, submits authorization/precertification requests with insurance companies, follows up on denied claims and/or authorizations, and submits appeals as necessary as a part of the revenue cycle team.
**Responsibilities**:
- Perform other duties as needed.
- Perform billing tasks assigned by management which may include data entry, claim review, charge review, accounts receivable follow-up, or other related responsibilities.
- Provide input on system edits, processes, policies, and billing procedures to ensure maximization of revenues.
- Perform daily tasks in assigned work queues and according to manager assignments.
- Identify payer, provider credentialing, and/or coding issues and address them with management.
- Follow workflows provided in training classes and request additional training as needed.
- Utilize CBO Pathways as guide for determining actions needed to resolve unpaid or incorrectly paid claims and/or for authorizing procedures in assigned workqueue(s) using payer websites, billing system information and training within expected timeframe.
- Review reports to identify revenue opportunities and unpaid claims.
- Adhere to general practices and FGP guidelines on compliance issues and patient confidentiality.
- Communicate with providers, patients, coders, or other responsible persons to ensure that claims are correctly processed by third party payers.
- Work following operational policies and procedures, and regulatory requirements.
- Responsible for assisting the professional billing staff within the CBO with difficult and escalated issues.
- Make appropriate corrections to system to satisfy/edit payer requirements and re-submit claims as needed.
- Cross cover other areas in the office as assigned by management including Accounts Receivable/Denials, Customer Service or Authorizations.
**Minimum Qualifications**:
To qualify you must have a High School Diploma or GED.
Experience in medical billing, accounts receivable, insurance, or related duties; Knowledge of CPT and ICD10; medical billing software; English usage, grammar and spelling; basic math; 2 years experience in a similar role.
