Job Description

Billing Specialist

Our full-time benefits include medical, dental, and vision insurance, matching HSA & 401k, PTO & paid holidays, The Villages Charter School eligibility, and much more!

Responsibilities:

Billing Specialist is responsible for ensuring that patient information is accurate and up to date, follow up on unpaid claims, resolve any discrepancies, and appeal denied claims to ensure that the healthcare provider is compensated for their services. Billing Specialists often communicate with patients to verify insurance details, inform them about their billing statements, and address any questions or concerns while ensuring compliance with HIPAA guidelines and other regulations. Essential duties and responsibilities may include, but are not limited to:

• Ensures all outstanding accounts receivable claims are followed up in a timely manner and appropriate actions are taken to resolve accounts and maximize collections.
• Monitor and respond timely and accurately to calls or correspondence from insurance companies.
• Submit pending and/or holding claims for your designated insurance group for all facilities within the appropriate time designated by the payer.
• Utilize your Athena Claim Worklist to prioritize and effectively work all denied claims, including held claims in Athena due to insurance rejections of claim status daily to ensure timely claims processing.
• Submit claim reconsiderations, appeals, and/or corrected claims as needed.
• Review all your assigned Athena cases and emails at least twice daily and respond to all within 24 hours with follow-up.
• Follow up with third-party payers on claims not paid according to contract.
• Submit secondary and/or paper claims for assigned payers as needed.
• Complete end of month checklist within the designated time frame.
• Provide exceptional customer service to patients by responding to their inquiries in a timely and professional manner.

Education/Experience Requirements:

• High school graduate.
• Two years' preferred experience and working knowledge in medical billing functions of third-party payer systems including Medicare and commercial insurance.
• Previous experience in the operation of office machinery including a copier, fax, computer, and printer.
• Proficiency in Microsoft products including Excel, Word, and Outlook.
• Proficient skills in computer programs.
• Customer service skills.
• Skillful in multitasking, prioritizing, and organizing.
• Ability to communicate effectively and work with others.
• Ability to communicate calmly and clearly with patients.
• Ability to understand and interpret policies and regulations.
• Ability to read and interpret medical charts.
• Ability to examine documents for accuracy and completeness.
• Operate standard office equipment including computers, fax machines, copiers, printers, telephones, calculators, etc.

Salary is commensurate with experience. Questions? Contact us at recruitment@thevillageshealth.com

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