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St. Joseph's/Candler

Medical Billing Specialist II

St. Joseph's/Candler, Savannah, Georgia, United States, 31441

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Responsibilities

The Medical Billing Specialist is responsible for taking all steps necessary to achieve complete account reconciliation.

Possesses and applies a thorough knowledge of the practice management billing systems and the ability to apply the knowledge to all aspects of the patient account including insurance, billing and collection.

Possesses and applies knowledge of CPT and ICD9 coding usage.

Obtains all necessary information for completing the billing process, including charge information from the physician.

Generates and submits collection notices and follows up on all patients due collection levels. Makes determination of possible assignment to outside collection agencies by complying with self-pay and bad debt policies.

Actively works through any denied claims and gathers needed information to ensure the claim is paid, facilitating appeals by correcting the claims or by pursuing an appeal.

Proactively researches and understands payer issues to troubleshoot front-end processes that cause denied claims.

Identifies coding errors and ensures charges are properly bundled or unbundled, and understands coding requirements for governmental and commercial payers.

Proactively identifies changes in billing requirements for governmental and commercial payors, keeping practice and billing office staff up to date with these changes.

Monitors accounts for registration/front-end errors and informs supervisors and the practice of repeat issues, assisting with training to reduce these errors.

Works claims that have not received responses from insurance by running reports and following necessary steps to ensure the claim is processed.

Responds promptly to inquiries from patients, co-workers, and supervisors regarding patient accounts in a kind and courteous manner.

Identifies credit balances caused by posting errors or insurance/patient overpayments.

Assists in providing quality training and orientation for assigned employees.

Posts and balances all payments, adjustments, and denials received on EOBs or ERAs accurately and timely, reporting any unidentified payments to the audit control coordinator.

Qualifications

High School Diploma or equivalent - Preferred

2 Years medical billing experience - Required

License & Certification: None Required

Seniority level

Entry level

Employment type

Full-time

Job function

Health Care Provider

Industries

Hospitals and Health Care

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