Wallingford, CT, 06494, USA
3 days ago
Billing Specialist
Billing Specialist Job Location: Wallingford Center, Connecticut Billing Specialist Masonicare Corporate Services - Wallingford, CT Day Shift / 40hrs/wk **THIS POSITION IS ON-SITE** Under general supervision from Patient Accounts Management, The Billing Specialist performs a variety of complex operations related to the eligibility, claim preparation, claim submission, suspense resolution, claim follow up and credit balance adjudication/reporting for healthcare services provided to Medicare, Medicaid and Commercial Primary/Secondary beneficiaries. Submits third party claims and resolves billing, payment and collection issues. Essential Duties and Responsibilities: - Review-reports to identify claims that are eligible for billing to intermediaries, insurance companies, third parties and patients. Processes claims and bills in Electronic Medical Record (EMR) system following established procedures. - Works with - operations to resolve - issues that impact claims processing. Brings problems and delinquent responses to the attention of Manager. Process- corrections - and generate- claims for re-processing. - - Reviews denials and zero pay claims from payor remittance advices, research issues and prepare-claims for resubmission. - Monitors unpaid claims via accounts receivable -aging, initiate- timely follow up calls and resubmit- claims and/or supporting information to receive- payment from payor. Work- under the direction of Manager to oversee timely collection- - -. - Maintains detailed claim history in collections database. Maintains statistical data and records. May prepare regularly scheduled or special reports on claims, suspense, denials, credit balances and payment activity. - Responds by telephone or correspondence to inquiries from patients, family, intermediaries or payers. Explain benefit coverage to patients, research- problems and correct-errors. - Identifies and investigates problem delinquencies; follow through with collection policy prior to referral to collection agency, legal action, or write off. - Meet- defined productivity metrics set up by Manager and maintain- - high-quality standards - -. - May assist in preparing documentation for appeals, third party audits, legal inquiries, litigation, and court appearances. Assists in special projects as needed. Perform general clerical duties to support the -team. - Work as a -cross-functional team member b=by providing training to others and -furthering training in our current systems as -appropriate. -Assist in documenting step-by-step task process- for each task and maintain a process manual at workstation. - Follows established departmental policies, procedures and objectives. - Performs miscellaneous job-related duties as assigned. Minimum Qualifications: Education: High School Diploma or GED Experience: 1 to 3 years’ experience in healthcare billing. Job ID: 12078 Share this Job Share this job with your friends and connections. + Facebook + X + LinkedIn + Email Job Alerts Email Address Areas of Interest Search for a category, location, or category/location pair, select a term from the suggestions, and click "Add". 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