Billing Specialist

As a Billing Specialist, your lead outcomes will include:

• Follow Insurance and Guest Aging of accounts through to complete resolution
• Lead efforts in reviewing accounts with outstanding balances and determining correct action to ensure reimbursement
• Establish payment arrangements with guests; monitoring payments and following up with guests as needed
• Manage work flow of the assigned accounts and prioritize the issues to meet deadlines for filing and reimbursement
• Meet monthly performance metrics

As a Billing Specialist, your core responsibilities will include:

• Review CPT, ICD-10 and modifier coding for accuracy
• Submit EDI claims and work clearinghouse rejection reports
• Post insurance and guest payments; perform necessary adjustments
• Review payment denials and claim rejections; research and resubmit within established time frames
• Document transactions to maintain adequate audit trail
• Process electronic guest statements
• Process electronic EOB's
• Prepare daily, weekly, monthly and yearly reports
• Review and resolve accounts with credit balances. Request refunds and/or adjustments as necessary
• Maintain work operations by following policies and procedures; reporting compliance issues
• Update job knowledge by participating in educational opportunities

As a Billing Specialist, DOC requires the following competencies:

• Behaviors and standards that model DOCs values and delivers a service experience that is unrivaled
• Certified Coder (CPC) or Certified Professional Biller (CPB)
• Minimum of 3 years Orthopedic billing experience
• Workers' Compensation Knowledge/Experience
• Solid understanding of PM/EMR systems
• Extensive knowledge of health insurance billing and processes, provider plans and payer contracts
• Ability to work independently
• Proactive leadership
• Active listening skills
• Behavior that is enthusiastic
• Enjoy working as part of a team
• Flexibility/Adaptability