Billing Specialist II-Ambulatory Services
Primary Care Specialist (PCS)
A Brief Overview
The role of the Billing Specialist II (Ambulatory Services) is to perform accurate and timely revenue capture to ensure standardization and application of best practices.
What you will do
- Reconciles and validates the accuracy of charges, enter charges in Lynx and review and/or correct potential errors. * Ensure services charged match documentation in current EMR System. * Reconcile and distribute vendor billed charges to the PDS/Partners as requested by supervisor for corrections/discrepancies. * Communicate problems and errors to management.
- Claims corrections duties include research, preparing appeals, claim submission and denial follow-up * Review rejected claims for accuracy of procedures, diagnoses, demographic and insurance information to correct and resubmit timely. * Review and correct all claims/charge denials and edits that are communicated via Explanation of Benefits (EOB) and other methods of communication. * Correct demographic, insurance and financial information for claim resubmission. * Obtain authorizations for resubmission
- Captures revenue in EMR system for daily direct patient charges. * Responsible for reconciling practice payments and charges includes office visits, procedures, POC testing, etc. * Reconcile charges before and after being sent to the billing vendor.
- Makes outbound and receives inbound calls from patients and insurance companies.
- Experience communicating via payor portals and working clearinghouse rejections.
- Candidate must have a thorough understanding of insurance eligibility, remits, payor guidelines and Medicare LCDs
- Maintains files and documentation thoroughly and accurately, in accordance with company policy and practices.
- Communicates effectively verbally and in legible writing.
- Interacts with employees and vendors in a professional manner.
- Adheres to established policies around HIPPA compliance/quality improvement measures, safety, environment and infection control standards.
- Assists in care and maintenance of department equipment and effective utilization of supplies.
- Participates in continuous educational opportunities.
Qualifications
- Associate's Degree Or equivalent education/experience in business, office administration or related field. Required
- Minimum 2 years experience Of progressive administrative/charge unit or related experience in a healthcare setting. Required and
- Experience with reconciling charges. Required
Physical Demands
- Standing - Occasionally
- Walking - Occasionally
- Sitting - Constantly
- Lifting - Rarely
- Carrying - Rarely
- Pushing - Rarely
- Pulling - Rarely
- Climbing - Rarely
- Balancing - Rarely
- Stooping - Rarely
- Kneeling - Rarely
- Crouching - Rarely
- Crawling - Rarely
- Reaching - Rarely
- Handling - Occasionally
- Grasping - Occasionally
- Feeling - Rarely
- Talking - Constantly
- Hearing - Constantly
- Repetitive Motions - Frequently
- Eye/Hand/Foot Coordination - Frequently
Regional One Health is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.
PI270932641
