Professional Billing & Insurance Follow-up Specialist

Responsibilities

• Perform medical billing functions for complex specialty accounts requiring advanced knowledge of multi-payer systems and specialty billing procedures and contracts.
• Review transactions to verify accuracy and completeness of charges.
• Research denied or incomplete bills.
• Verify ICD-10 coding.
• May specialize in a general payer type or bill type such as capitation, commercial, government, behavioral health, or specialty.

Qualifications

• High school diploma or equivalent.
• One year of healthcare clerical experience or applicable billing/credit/collections experience.
• Healthcare billing or credit/collections experience preferred.
• Education may be substituted for the experience requirement.

Skills

• Familiarity with specialty billing procedures and contracts.
• Accuracy in data entry and billing processes.
• Knowledge of multi-payer systems.
• Knowledge of billing and collection rules and regulations.
• Knowledge of online systems for eligibility and claim status review preferred.
• Familiarity with billing software and electronic medical records, including Microsoft Office and 10-key proficiency.
• Knowledge of medical terminology preferred.
• Ability to resolve billing issues and handle denied claims.
• Ability to work efficiently with minimal supervision and exercise independent judgment within stated guidelines.
• Strong interpersonal, organizational, and communication skills.
• Ability to adapt to change.