Billing Specialist

• Oversee the billing process for customers and patients
• Coordinate and execute processes of front-end medical billing of commercial insurance and government program claims for all Cardiology devices
• Ensure all posting of charges are accurate
• Submit and re-submit billing data to the appropriate insurance providers
• Process claims
• Resolve denial instances
• Achieve maximum reimbursement for services provided across all lines of business (Commercial/Medicare/Medicaid, etc.)
• Ensure the efficiency of billing operations by following federal and state billing regulations
• Review supporting documentation and posted charges for completeness and accuracy
• Complete quality review of patient files to ensure claims are billed accurately and comply with each payer’s rules and regulations
• Generate commercial insurance and government program claims in the system and review for accuracy
• Conduct audits regularly
• Perform necessary follow-up functions for timely processing of claims
• Assist with managing unbillable revenue, clearinghouse rejected claims, and other reports daily
• Reference reimbursement policies/procedures assigned to this role and maintain knowledge with changes in billing regulations
• Identify any areas of opportunity for improved documentation or efficiency
• Follow-up on unbilled claims within the required billing time limits
• Follow-up with any insurance companies regarding any discrepancies to payments
• Quality review of patient and insurance accounts for follow-up as needed to ensure ICD-10 diagnosis is properly documented
• Perform other projects and duties as assigned

• High school diploma or equivalent required
• 3+ years of experience in a medical related business environment required
• Billing database software experience required
• Clearinghouse and payer portal experience preferred
• Knowledge of insurance industry and third-party payer processes
• Proven data entry skills required
• Ability to organize and prioritize workload
• Strong attention to detail and accuracy
• Ability to work independently and manage workload
• Strong written, verbal, and interpersonal communications
• Must be proficient in Excel

Clearinghouse and payer portal experience

• Support for Parents
• Continuing Education/ Professional Development
• Employee Heath & Well-Being Benefits
• Paid Time Off
• 2 Days a Year to Volunteer
• Medical and dental coverage that start on day one
• Insurance coverage for basic life, accident, short-term and long-term disability, and business travel accident insurance
• Employee Stock Purchase Plan (ESPP)
• 401(k) Retirement Savings Plan (RSP)
• Flexible Spending Accounts
• Educational assistance programs
• Paid holidays
• Paid time off ranging from 20 to 35 days based on length of service
• Family and medical leaves of absence
• Paid parental leave
• Commuting benefits
• Employee Discount Program
• Employee Assistance Program (EAP)
• Childcare benefits