The CBO Representative is responsible for accurate and timely billing and follow-up of all claims to ensure prompt payment from all payers. This role also includes communication and research regarding patient accounts with internal departments and external payers.

Key responsibilities include:

Run daily reports to prepare billing follow-up for patient accounts with Medicare, Medicaid, Blue Cross, commercial, and other third-party payers.
Make outgoing and receive incoming calls to answer patient and insurance questions regarding claims status and billing.
Ensure accurate and timely follow-up with insurance companies according to established policies and procedures.
Review patient account information from admissions and outpatient registration to identify missing information and determine next steps.
Respond to billing questions and provide clarification to customers.
Maintain communication with insurance payers, outside agencies, and internal departments.
Refer non-routine issues to management for clarification.
Prepare and update correspondence to customers and insurance payers as needed.
Process and scan EOBs and correspondence within 2 business days.
Re-bill and reprocess denials and rejections to resolve issues with insurance payers.
Take incoming calls from patients regarding insurance and billing.
Process walk-ins.
Resolve credit balance reports monthly.
Work collaboratively and professionally with all staff.
Perform other duties assigned by the Director of PFS or Executive Director of Revenue Cycle.
Work the denial program daily.

Billing Specialist