Billing Specialist (Full-time, part-time)

CETC is seeking a billing specialist to provide medical billing services such as the processing, submission, and payment of patient charges and appropriate follow-up with insurance companies and clients. They provide outstanding professional and interpersonal customer service by means of email, phone calls and in-person conversations. They take the lead in ensuring insurance coverage for a patient’s continuation of care and flow of revenue for the continued growth of CETC.

The ideal candidate for this role will be a self-motivated individual who is able to resolve issues independently with an understanding of when to approach leadership for input and direction. This role can be worked from in the office or part-time in office and at home.

Essential Responsibilities and Duties:

· Proficiently and effectively uses the Practice Management and EHR Software to utilize the billing system database to update facility file, payer information and patient demographic information, to send, edit, receive, and resubmit claims within billing system and assure correct balance of charge and payment batches, and proper reconciliation.

· Submit claims to payers via SFTP and CMS-1500 claim forms and follows up on any denials or rejections within timely filing.

· Initiate appeals, corrects claim submissions, and submit medical records in response to payer requests for information or claims denials within the payor’s timely filing guidelines.

· Utilize Clearinghouse to ensure claims are being received by payers, resolve any rejected claims, and can interpret and upload ERAs received from payers.

· Processes and uploads payments received by ERAs/EOBs into Simple Practice and ensures patient charges and claims accurately reflect their response.

· Performs independent research prior to seeking management assistance.

· Successfully navigate payer websites, phone systems, fax processes and conversations with call representatives to obtain accurate and detailed insurance information.

· Employ effective and efficient billing techniques, and self-directed initiative, to resolve all types of billing edits.

· Keeps detailed records and documentation of any correspondence with payers, clients and any active claims and/or appeals being worked on.

· Review and analyze medical records to ensure accurate coding and billing.

· Communicate with providers, when necessary, to clarify documentation is accurate, up to date and compliable with payer billing requirements.

· Maintain patient confidentiality and adhere to HIPAA regulations.

· Comply and stay updated with all relative coding and ICD-10 guidelines and regulations.

· Ensure all clients remain informed of any outstanding debts and provides solutions to any of the client’s relative problems.

· Provide excellent and compassionate customer service to resolve issues within an appropriate time frame, showing persistence, and seeking alternatives when obstacles arise.

Skills:

· Excellent verbal and written communication and interpersonal skills. Ability to develop and maintain effective relationships with office staff and clients to create confidence, respect, and dependability.

· Displays professionalism in the workplace maintaining a positive team attitude; demonstrates dependability in attendance and timeliness

· Demonstrated ability to utilize Microsoft Outlook, Word, and Excel software applications.

· Ability to learn and familiarize themselves with EHR software and clearinghouse.

· Established knowledge of major payers to identify payer rejection issues and execute the payer procedures needed to reduce the occurrence of future rejections.

· Impressive attention to detail and accuracy within their scope of billing and with any relative/necessary documentation or medical records

· Excellent multitasking, prioritizing and organizational abilities.

· Familiarity with basic office equipment (ex: multi-line phone system, fax machine, photocopier, PC, etc.)

· Can learn basic front desk roles to occasionally answer phone calls from clients, while communicating and following office policies

 Bachelor’s degree in related field (Preferred)

· Minimum of three (3) years’ experience of medical billing and working with an Electronic Health Record software (EHR)

· Minimum of one (1) year of customer service experience.

Job Types: Full-time, Part-time

Pay: $21.00 - $24.00 per hour

Expected hours: 20 – 40 per week

Benefits:

• Health insurance

• Paid time off

• Retirement plan with Employer matching

Schedule:

• Monday to Friday

• No weekends

Work setting:

• Hybrid work

• Office

• Private practice

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