Location: Norfolk, Virginia US
Job Number: 1286
Position Title: Billing Specialist
The Billing Specialist will serve as an information resource and guide to our providers, clinical staff, practice managers, members of the Revenue Cycle and Client Services teams and other leadership. This position will be directly involved in analyzing pre-bill claim edits, claim denials and accounts receivable (AR) management, and working alongside the Revenue Cycle Specialists will research, review and amend claims to ensure adherence to payor policy requirements.
Duties and responsibilities:
- Identify charge capture opportunities through report monitoring, hospital record inquiry and other reconciliation methods
- Support charge capture and claims submission process for multiple practices while monitoring and adhering to timely filing requirements
- Resolve pre-bill edits and rejections related to patient demographics, insurance coverage, medical policy and other practice/payor requirements
- Research, analyze, and respond to inquiries regarding compliance, payor policies and guidelines, coding, denials, and billable services
- Complete AR follow up processes, including claim corrections, appeals, payor follow up and resubmissions to expedite reimbursement
- Audit medical record documentation to identify coding discrepancies and attach records where required
- Support coding team in obtaining clarification of conflicting, ambiguous, or non-specific documentation through provider queries
- Interact with Revenue Cycle Management team and practice staff to ensure appropriate and complete follow-up of patient accounts
- Review, develop, modify, and adapt relevant client procedures, protocols, and data management systems to ensure compliance with organization’s policies
- Illustrate excellent knowledge of healthcare industry regarding the revenue cycle, coding, claims, and state insurance laws, serving as an information source, subject matter expert and guide to clinicians
- Ensure strict confidentiality of financial and medical records
- Perform miscellaneous job-related duties as assigned to impact revenue or drive efficiencies
- Advanced knowledge of medical coding, billing systems, auditing concepts and regulatory requirements
- Ability to use independent judgment and to manage and impart confidential information
- Ability to analyze and solve problems
- Strong communication, presentation, and interpersonal skills
- Knowledge of legal, regulatory, and policy compliance issues related to medical billing procedures and documentation
- Knowledge of current and developing issues and trends in medical billing procedures
- Ability to clearly communicate medical information to professional practitioners and/or the public
- Ability to provide guidance and training to professional and technical staff in area of expertise
- Minimum of 3 years’ experience as a biller, coder, or other equivalent administrative medical industry experience
- Intermediate Microsoft Excel skills
- Certified Professional Coder (CPC) preferred
- Associates degree from an accredited university preferred
- Athena experience preferred, but not required
- Experience with Salesforce is a plus
Community / Marketing Title: Billing Specialist
Unified Women’s Healthcare is a company dedicated to caring for Ob-Gyn providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this, but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob-Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
Remote Opportunity: 1
EEO Employer Verbiage:
We offer a competitive salary and an excellent benefit package that includes health/dental/life/STD/LTD/vision insurance, paid time off, and 401(k) plan. This company is a drug-free workplace and an Equal Employment Opportunity employer.