Billing Specialist
$38,147–$38,147 year
On-siteSpringfield, Illinois, United States
Job Summary
Receive and examine daily billing claim listings to determine which require further analysis, then investigate incomplete or incorrect information to resolve complex errors and ensure compliance with managed care guidelines. Prioritize claims based on specified criteria, file them electronically or via paper, and research rejected account information to resolve rejection reasons and secure required data. Communicate and resolve issues with internal departments, patients, third-party payors, and collection agencies while initiating corrections to charges and calculating write-off amounts. Document online systems and electronic files to track claim status and payments, and provide input on system edits for consistent, compliant data processing.
Required Qualifications
- Education equivalent to graduation from high school or GED
- Two or more years as a Billing Specialist (or comparable medical claims/billing experience)
- Technical knowledge to process all types of applicable claims and resolve errors and complex issues associated with them
- Thorough knowledge of medical terminology
- Knowledge of medical procedural (CPT) and diagnosis (ICD-9 CM) coding
- Knowledge of hospital billing claim form UB04
- Comprehensive knowledge of the electronic billing system
- Knowledge of key contract billing guidelines
- Ability to train others on the entire billing process
- Basic working knowledge of personal computers and their associate user software
- Ability to work within the guidelines of defined managed care contract policy provisions and company procedures
- Ability to work successfully with internal customers and external contacts
- Highly-developed detail orientation
- Critical thinking ability
- Problem solving ability
- Excellent oral and written communication skills
- Keyboarding skills
- Basic math skills
- Ability to work unsupervised
- Ability to work in a group setting
Desired Qualifications
- Experience with Microsoft Office products Word and Excel
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