Billing Specialist

Process customer bills and insurance claims accurately and timely, including daily and month-end billing functions, procedures, and reporting. Research and establish patient eligibility with insurance providers, reverify benefit coverage, and resolve billing issues regarding eligibility, coverage, and related benefits. Accurately enter patient information into pharmacy and billing systems, audit patient files for compliance, and perform prescription claims adjudication to address rejections or prior authorizations. Provide guidance to residents and responsible parties on Medicare plans and proactively review profiles to save costs. Manage daily census, admit, discharge, and room changes while processing payments, returns, and credits. Rotate through other departments to gain functional knowledge of workflows.