Billing Specialist

6 days ago

Washington, Washington, D.C., United States T & N Reliable Nursing Care Full time $50,000 - $60,000 per year

Job Title: Billing & Payroll Specialist

Hours: Monday – Friday, 8:30 am to 5:00 pm

Job Type: Full-time

Reports to: Billing & Payroll Manager

Job Description: The medical biller is responsible for the timely submission of medical claims to insurance companies. Medical billing is very detailed oriented and requires a lot of attention. The medical biller needs to understand how to read medical records such as, the diagnosis code. He/she should be familiar with HCPCS Level II and ICD-10-CM codes. Also, the medical biller should understand how prior authorization and NPI numbers work. Medical billing consists of translating a healthcare service into a medical billing claim. The responsibility of the medical biller at T&N Reliable Nursing Care is to bill claims, follow the claims to ensure the practice receives proper reimbursement for the work the providers perform.

Job Responsibilities:

The essential functions for the Medical Biller include the following:

  • Prepares and submits patient claims to appropriate third party payers
  • Reviews claims to ensure that payer specific billing requirements are met
  • Resolves routine and non-routine patient billing inquiries and problems
  • Collects patient documentation for claim submission
  • Ensures claim forms are completely and accurately filled-out
  • Updates and maintains patient billing data and ensures documents are current
  • Follow up on unpaid claims within standard billing cycle timeframe
  • Contacts clinical staff for clarification on procedures or diagnosis and on missing information
  • Updates billing software with rate changes and other appropriate information
  • Follow up on denials
  • Verifies and updates patient's insurance coverage
  • Investigate and resolve any discrepancies
  • Answers patient's billing questions
  • Posting payments received from patients and third-party payors.
  • Processes and obtains authorization requests for services (current and retro)
  • Verifying the accuracy of Authorizations
  • Using codes to bill insurance providers

  • Learn and provide assistance to processing bi-weekly payroll.

  • Familiarity with classification diagnosis and ICD 10 codes

  • Familiarity with billing software such as Sandata, Paycom and others related to the field
  • Keeping track of patient data over multiple visits
  • Maintain patient confidentiality and information security
  • Data entry ability
  • Computer literacy and experience in MS word and Excel
  • Ability to work well in a team environment. Being able to `prioritizes, delegate tasks if needed, and handle conflict in a reasonable fashion
  • Ability to pull correctly reports out of software; paying attention to details.
  • Effective communication abilities for phone contacts with insurance payers to resolve issues
  • Problem-solving skills to research and resolve discrepancies, denials, appeals, and collections
  • Knowledge of medical terminology likely to be encountered in medical claims
  • Ability to multitask

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