Appalachian Regional Healthcare (ARH)
Clinic Billing Specialist
Appalachian Regional Healthcare (ARH), Frankfort, Kentucky, United States
Overview
Under general supervision, the Clinic Billing and Follow‑Up Specialist handles essential billing and insurance follow‑up functions. This role requires a fundamental understanding of insurance claim processing, knowledge of HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handle denials, and perform follow‑up with insurers to ensure claims resolution. The position encompasses business office responsibilities related to patient accounts, including charge import, appeals, diagnostics and procedural coding, and claim follow‑up with third‑party payers to achieve a zero‑balance resolution.
Special Instructions
Position is On‑Site with Hybrid work option after six months
Responsibilities
Promote the mission, vision, and values of the organization
Import charges from queues in a timely manner and append modifiers or required info for claim transmission
Review daily accounts ready to be billed in Waystar from Meditech
Initiate correction on all claims with errors by designated time
Follow up on any correspondence that may have been received on that day or the previous day
Cross train on billing all lines of business to the different payers
Pull listing of all accounts assigned to be follow up by specific payer
Diagnostic and procedural coding
Follow‑Up Responsibilities
Responsible for the resubmission of primary, secondary, and tertiary claims per regulations and policies
Communicate with third‑party representatives as necessary to complete claims processing and/or resolve problem claims
Follow‑up daily on post processing activity including rejected billings, adjustments, rebilling, and denied claims for accounts
Maintain accounts receivable detail of accounts through tasking
Maintain standards per payer for percentage accounts > 90 days
Work minimum standard number of accounts per payer per day
Meet or exceed collection goals by payer each month
Work all assigned accounts as assigned, depending on balance
Complete appeals as required
Participate in educational activities and attend monthly department staff meetings
Maintain confidentiality: adhere to HIPAA guidelines/regulations
Other duties as assigned from time to time
Qualifications
High School Diploma or GED
Six months previous experience in clinic registration, billing and collections, financial counseling, or customer service preferred
Knowledge of medical terminology preferred
Basic computer proficiency
Typing speed: minimum 40 WPM
Familiarity with CPT and ICD‑9 coding is helpful
Good written and verbal communication skills essential for account follow‑up
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Under general supervision, the Clinic Billing and Follow‑Up Specialist handles essential billing and insurance follow‑up functions. This role requires a fundamental understanding of insurance claim processing, knowledge of HCFA claim forms, and the ability to interpret insurance explanation of benefits (EOBs), handle denials, and perform follow‑up with insurers to ensure claims resolution. The position encompasses business office responsibilities related to patient accounts, including charge import, appeals, diagnostics and procedural coding, and claim follow‑up with third‑party payers to achieve a zero‑balance resolution.
Special Instructions
Position is On‑Site with Hybrid work option after six months
Responsibilities
Promote the mission, vision, and values of the organization
Import charges from queues in a timely manner and append modifiers or required info for claim transmission
Review daily accounts ready to be billed in Waystar from Meditech
Initiate correction on all claims with errors by designated time
Follow up on any correspondence that may have been received on that day or the previous day
Cross train on billing all lines of business to the different payers
Pull listing of all accounts assigned to be follow up by specific payer
Diagnostic and procedural coding
Follow‑Up Responsibilities
Responsible for the resubmission of primary, secondary, and tertiary claims per regulations and policies
Communicate with third‑party representatives as necessary to complete claims processing and/or resolve problem claims
Follow‑up daily on post processing activity including rejected billings, adjustments, rebilling, and denied claims for accounts
Maintain accounts receivable detail of accounts through tasking
Maintain standards per payer for percentage accounts > 90 days
Work minimum standard number of accounts per payer per day
Meet or exceed collection goals by payer each month
Work all assigned accounts as assigned, depending on balance
Complete appeals as required
Participate in educational activities and attend monthly department staff meetings
Maintain confidentiality: adhere to HIPAA guidelines/regulations
Other duties as assigned from time to time
Qualifications
High School Diploma or GED
Six months previous experience in clinic registration, billing and collections, financial counseling, or customer service preferred
Knowledge of medical terminology preferred
Basic computer proficiency
Typing speed: minimum 40 WPM
Familiarity with CPT and ICD‑9 coding is helpful
Good written and verbal communication skills essential for account follow‑up
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