ALN is now part of the Health Prime family! The Billing Specialist manages healthcare claims processing for physician practices across the US. They work in a team environment with specific work processes assigned to each team member. They will work closely with others across the revenue cycle to ensure timely and quality performance for assigned clients.
The Billing Specialist will enjoy autonomy and independence while collaborating in a team environment.
Duties/Responsibilities:
• Able to communicate with assigned clients related to day-to-day operations through rework, emails, etc.
• Identifies trends and communicates to Supervisor/Manager with data examples or system reports as available.
• Uses reports and workflow to monitor daily operations and performance; working with leadership to address positive/negative trends.
• Responsible for completing assigned tasks while meeting productivity and quality standards.
• Reviews and resolves escalated problem logs including problems with payments, charges and A/R.
• Coordinates and processes claims by researching, compiling necessary information, and taking appropriate next steps to resolve the claim. All actions should be appropriately documented in client PM system.
• Able to assist with review of client insight reports and other reporting tools to help identify potential problems which may include special projects.
• Able to provide process feedback to offshore through system workflow and or escalation to Supervisor/Manager with data examples.
• Actively participates in team specific meetings, training and education.
• Able to research credit balances, validates and recommends refunds, transfer of payments and accounts for potential collections.
• Able to research, validate and recommend uncollectible status and/or adjustments of delinquent third party payer balances.
• Responds to patient team emails appropriately and timely.
• Other duties as may be assigned.
Required Skills / Attributes/ Experience:
- 1 or more years’ experience in Medical Billing preferred.
- Degree in Medical Billing or a similar field is desirable.
- Proficient with Microsoft Office suite of products, Excel, Word, PowerPoint and Outlook in addition to excellent 10 key and mathematical skills.
- Knowledge of insurance submittal procedures and medical forms (including UB92 and HCFA 1500) and physician reimbursement preferred.
- Previous experience working with Athena (GE) Centricity and NextGen billing systems desired but not required.
- Actively supports change.
- Capable of making timely independent decisions.
- Inspires respect and trust.