Billing Specialist

1 week ago

Milwaukee, United States Caretruly Healthcare Full time

**Benefits**:

- Paid time off

The Billing Specialist is responsible for calculating and collecting payments for services.

**JOB DESCRIPTION**
- Submits medical claims to insurance companies and payers such as Medicare and Medicaid, Community Care, Molina Healthcare, etc.
- Update patient data, develop payment plans, and prepares invoices.
- Ensure that patients and insurance providers are billed quickly and accurately.
- Reviewing patient bills for accuracy and completeness and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle timeframe.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Calling insurance companies regarding any discrepancy in payments if necessary
- Identifying and billing secondary or tertiary insurances.
- Reviewing accounts for insurance accuracy.
- Responsible for reviewing, researching, investigating, negotiating, processing and adjusting all claims including denied claims as necessary.
- Setting up patient payment plans and work collection accounts.
- Participate in the on-call rotation to ensure holiday, weekend and after hour coverage.
- Back fill position of Personal Care Worker, Staffing Scheduler and Processor.

**Knowledge/Special Skills/Abilities Needed**:

- Knowledge of ICD-10 and CPT coding.
- Effective oral and written communications and presentation skills are essential, as are interpersonal skills.
- Ability to make administrative and procedural decisions and judgments on sensitive, confidential issues.
- Ability to work effectively in a team environment.
- Ability to gather and analyze statistical data and generate reports and to plan, coordinate and administer complex administrative systems and processes.
- Ability to work with frequent, established deadlines.
- Ability to develop, plan, and implement short
- and long-range goals.
- Ability to be very organized and focused on regulations and billing needs.
- (This list of duties and responsibilities is not all inclusive and may be expanded to include other duties and responsibilities, as management may deem necessary from time to time)_

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