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Healthcare Billing Specialist
2 months ago
Job Overview:
A Healthcare Billing Specialist is an essential component of the financial operations within medical facilities, contributing significantly to their economic stability.
The Healthcare Billing Specialist is responsible for navigating the complexities of the billing cycle, which includes thoroughly examining medical records and liaising with insurance providers and patients.
Key Responsibilities:
A primary duty is to manage billing processes, which involves generating and submitting claims to various insurance entities and payers.
This necessitates a meticulous approach to confirm the accuracy and completeness of patient data, diagnoses, and treatment codes, adhering to established coding standards such as ICD-10 and CPT.
Insurance verification plays a critical role in this position, requiring a solid understanding of insurance policies and protocols.The Healthcare Billing Specialist verifies patient insurance coverage, secures necessary authorizations, and ensures compliance with insurance guidelines to facilitate a smooth billing process.
In addition to coding and billing functions, this position entails proactive follow-up on pending claims.The Healthcare Billing Specialist monitors and addresses claim denials, engaging in effective dialogue with insurance companies to resolve discrepancies and ensure timely payments.
This requires a strategic and persistent approach to achieve favorable financial results for the healthcare organization.Patient interaction is another vital aspect of this role, involving communication to clarify billing information, assist with financial questions, and establish payment plans.
A successful Healthcare Billing Specialist not only excels in the technical aspects of billing but also possesses strong interpersonal skills to communicate effectively with patients in a clear and compassionate manner.
Staying informed about healthcare regulations and insurance policies is crucial to maintain compliance with industry standards and legal obligations.The Healthcare Billing Specialist is expected to keep organized and accurate billing records, produce insightful reports on financial performance, and collaborate efficiently with other healthcare professionals to ensure a seamless billing experience.
In summary, the role of a Healthcare Billing Specialist requires a combination of technical expertise, attention to detail, excellent communication skills, and a dedication to navigating the intricate landscape of healthcare finance to optimize revenue for the medical facility.
Perform additional duties as assigned.Qualifications & Experience:
2-5+ years of experience in outpatient billing and collections
Familiarity with NCCI editing
Understanding of Commercial and Government payer and Worker's Comp guidelines
Proficient in medical terminology, HIPAA, and other essential regulatory standards
Highly organized, detail-oriented, and capable of meeting deadlines.
Ability to interpret various insurance documents, analyze and reconcile accounts, and follow detailed procedures in an efficient and organized manner.
Strong computer skills (Word, Excel, billing software)PHYSICAL DEMANDS
Requires visual acuity to inspect and analyze work closely and the ability to hear sound with or without correction; Ability to climb, stoop, kneel, reach, stand, walk, pull, push, lift, and exert up to 40 pounds of force occasionally and/or up to 10 pounds of force constantly to move objects.
The physical demands for this position include adequate vision, hearing, and repetitive motion.
Ascending or descending stairs, ramps, and similar tasks, using feet and legs and/or hands and arms.
Substantial movements (motion) of the wrist, hands, and/or fingers in a repetitive manner - Bending legs downward and forward by bending leg and spine - Standing, particularly for sustained periods of time.
Using upper extremities to exert force to draw, drag, haul, or tug objects in a sustained motion.Raising objects from a lower to a higher position or moving objects horizontally from position to position.
WORK CONDITIONS
While performing the duties of this role, the employee is frequently required to stand, walk, sit, reach with hands and arms, and talk or hear.
The employee must have close visual acuity to perform activities such as preparing and analyzing data and figures, transcribing, and viewing a computer terminal.
