Position Overview: Reporting to the Billing Manager, Billing Specialists are responsible for the daily entry of charges for their assigned surgical centers. This will include but is not limited to the following: perform complete chart reviews, verify patient demographics, assign modifiers, diagnosis codes, and revenue codes in accordance with coding and reimbursement guidelines resulting in claim reimbursement.
Responsibilities:
- Pull any preoperative notes from the designated transcription company.
- Extract information from medical records, operative notes, invoices, progress notes and discharge paperwork to ensure completeness and accuracy of charge entry.
- Capture implants, high-cost supplies, high-cost drugs, post op pain blocks and observations times prior to charge submission
- Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.
- Execute the recurring billing workflow and generate and transmit claims daily.
- Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).
- Reconcile revenue and billing during the period-end close process.
- Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.
- Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.
- Maintain current knowledge of health care billing laws, rules and regulations and developments
Required Skills
Requirements:
- 2+ years of ASC revenue cycle or orthopedic charge entry or collections experience.
- Ability to read and interpret insurance explanations of benefits and managed care contracts.
- Must communicate effectively, both verbally and in writing, with internal and external clients.
- Must be able to multi-task and handle competing priorities while meeting or exceeding deadlines
- Knowledge or experience working with a variety of health care insurance payers is preferred
- Intermediate computer proficiency in Microsoft Office including Excel and Outlook
- Advantx, Vision, HST, Waystar experience preferred.
- High School Diploma or equivalent.
Required Experience