Cohesive Healthcare Management
Corporate Billing Specialist
Cohesive Healthcare Management, Oklahoma City, Oklahoma, United States, 73116
Position Summary
A Corporate Billing Specialist plays a crucial role in ensuring accurate and timely billing processes within a corporate environment. This role involves working closely with various departments and clients to generate invoices, track payments, and resolve billing discrepancies. The specialist is responsible for maintaining a high level of financial accuracy and integrity while promoting positive client relations.
Responsibilities
Prepare and submit billing to assigned payors / insurance companies
Prepare deposits; distribute / post payments for assigned payors / insurance companies
Follow up on billing questions for clients as well as clinical staff
Follow up on outstanding balances with assigned payors / insurance companies
Maintain payment status and billing records
Track and resolve billing discrepancies
Flag write-off recommendations for assigned payors / insurance companies
Prepare client billing statements, review for accuracy and ensure that they are sent in a timely manner
Gather, analyze, and respond to member and provider appeals, ensuring compliance with standards
Maintains a caseload and monitors day to day compliance of appeal decision time frames
Responds to member, provider, and client telephone inquiries regarding status, process and outcome of appeals
Coordinates and distributes first, second and third level appeal request assignments
Consults with managers on problem cases and interfaces with case managers, clinical supervisors, account managers and other personnel in resolving denial and appeal questions
Provide accurate and timely responses to appeals, grievances and all other correspondence
Responsible for ensuring all determination responses are compliant with all established regulations
Communicate effectively with individuals / teams to ensure high quality and timely expedition of customer requests
Assist Customer Service in responding to and resolving customer questions and concerns related to correspondence
Requirements
High school diploma required. A bachelor's degree in accounting, finance, or a related field preferred.
Proven experience in billing, invoicing, or accounting.
Strong attention to detail and numerical accuracy.
Excellent communication and interpersonal skills.
Proficiency with billing software and accounting systems.
Knowledge of relevant laws and regulations in the billing field.
Strong problem-solving and analytical abilities.
Ability to work independently and as part of a team.
Time management skills and the ability to prioritize tasks effectively.
Must have AR experience.
Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.
While performing the duties of this position, the employee is regularly required to:
Talk or hear
Use hands or fingers, handle, or feel objects, or controls
Stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl
Lifting and moving up to 25 pounds occasionally
Maintain close vision, distance vision, color vision, peripheral vision and the ability to adjust focus
Work in a moderate noise environment
Travel to various locations as required
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Responsibilities
Prepare and submit billing to assigned payors / insurance companies
Prepare deposits; distribute / post payments for assigned payors / insurance companies
Follow up on billing questions for clients as well as clinical staff
Follow up on outstanding balances with assigned payors / insurance companies
Maintain payment status and billing records
Track and resolve billing discrepancies
Flag write-off recommendations for assigned payors / insurance companies
Prepare client billing statements, review for accuracy and ensure that they are sent in a timely manner
Gather, analyze, and respond to member and provider appeals, ensuring compliance with standards
Maintains a caseload and monitors day to day compliance of appeal decision time frames
Responds to member, provider, and client telephone inquiries regarding status, process and outcome of appeals
Coordinates and distributes first, second and third level appeal request assignments
Consults with managers on problem cases and interfaces with case managers, clinical supervisors, account managers and other personnel in resolving denial and appeal questions
Provide accurate and timely responses to appeals, grievances and all other correspondence
Responsible for ensuring all determination responses are compliant with all established regulations
Communicate effectively with individuals / teams to ensure high quality and timely expedition of customer requests
Assist Customer Service in responding to and resolving customer questions and concerns related to correspondence
Requirements
High school diploma required. A bachelor's degree in accounting, finance, or a related field preferred.
Proven experience in billing, invoicing, or accounting.
Strong attention to detail and numerical accuracy.
Excellent communication and interpersonal skills.
Proficiency with billing software and accounting systems.
Knowledge of relevant laws and regulations in the billing field.
Strong problem-solving and analytical abilities.
Ability to work independently and as part of a team.
Time management skills and the ability to prioritize tasks effectively.
Must have AR experience.
Physical Demands and Work Environment The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.
While performing the duties of this position, the employee is regularly required to:
Talk or hear
Use hands or fingers, handle, or feel objects, or controls
Stand; walk; sit; reach with hands and arms; climb or balance; and stoop, kneel, crouch or crawl
Lifting and moving up to 25 pounds occasionally
Maintain close vision, distance vision, color vision, peripheral vision and the ability to adjust focus
Work in a moderate noise environment
Travel to various locations as required
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