Billing Specialist

ESSENTIAL JOB RESULTS:
➢ Utilizes Nextgen PM and dedicated portals for payment processing, claim submission and claim edits.
➢ Assures appropriate cash flow into the company by auditing bills for completeness and corrections upon billing and posting of medical claims.
➢ Submits bills and posts payments in a timely fashion to the appropriate payers. Performs follow up on accounts to ensure that payment is received.
➢ Maintains accurate information on patient accounts and payer balances. Reviews accounts to make sure payments are being posted appropriately and that charges have been posted accurately.
➢ Works account aging.
➢ Arranged payment plans with patients.
➢ Support with pharmacy payments reconciliations, lab invoices, hospital invoices, etc.
➢ Perform account reconciliations, restructures, and cash application investigations.
➢ Supports with chart audits.
➢ Processes payments in person and over the phone and settle payment agreements.
➢ Processes insurance and patient credits and refunds.
➢ Provides patients with Good Faith Estimate (GFE).
➢ Works with the Billing Supervisor to ensure that all goals are being met and that accounts are being resolved in timely manner.
➢ Works with the Billing Supervisor to ensure that team members are being trained fully and that they understand the way the department functions. Serves as a mentor to other team members as needed.
➢ Works with front office and location cashiers to ensure that they are performing their jobs in the most effective way for billing purposes. Assists with training and implementation of new processes for all clinic staff when needed.
➢ Contributes to team efforts by accomplishing results as needed and complying with all facility policies and procedures. Including but not limited to policies and procedures addressing HIPAA and Compliance. Encourages other team members to do the same.
➢ Assist with other billing department projects and activities as assigned by AR & Billing Manager and Billing Supervisor.