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Billing Specialist I
Billing Specialist IGBMC Healthcare • Perry Hall, Maryland, USA
Billing Specialist I

Billing Specialist I

GBMC Healthcare • Perry Hall, Maryland, USA
[job_card.variable_days_ago]
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  • [job_card.full_time]
[job_card.job_description]

Under direct supervision performs all billing and collection functions on account balances within assigned financial classes. Ensures timely submission of all claims and timely follow up. Posts payments in EPIC. Perform eligibility verification and authorization requests as needed.

Education

High School diploma or equivalent required. Associates degree preferred.

Experience

Two years of medical billing experience and one year experience with electronic billing.

Epic experience desired.

Knowledge Skills and Abilities

  • Thorough knowledge and understanding of medical billing insurance and private pay.
  • Knowledge of all medical billing requirements for Medicare Blue Cross Medical Assistance Commercial insurance and HMO carriers
  • Strong collection skills including claims follow-up revenue cycle practices
  • Strong computer skills including EMR knowledge and Microsoft Office. Excel preferred.
  • Strong interpersonal skills
  • Excellent verbal and written communication skills for interacting with patients families insurance companies and healthcare providers.
  • Strong ability to investigate issues find solutions and work under pressure to resolve billing issues.
  • Efficient in managing multiple tasks prioritizing and ensuring deadlines are met.
  • Ability to handle multiple claims and billing tasks simultaneously while maintaining quality and accuracy

Licensures Certifications

N / A

Principal Duties and Responsibilities

  • Manages assigned Epic work queues daily to ensure accurate billing and expedient claims follow-up.
  • Claims Billing Processes

  • Ensures timely submission of all claims within assigned financial classes.
  • Ensures timely follow up of all claims within assigned financial classes
  • Claim Resolution Processes

  • Investigates claim denials or rejections
  • Completes functions in order to resolve claims
  • Uses all available tools such as but not limited to : Online access calling the insurance companies; working with provider representatives.
  • Identifies appeals
  • Identifies secondary billing for accounts with secondary liability; follows-up on any unpaid balances. Brings these claims to resolution.
  • Identifies patient self-pay balances and bills timely to patient / family. Follow-ups as necessary including calling for follow up.
  • Process any late charge claims claims resubmission and / or claims corrections to payors.
  • Enters and posts payment to patient accounts based on remittance advice review.
  • Reconcile accounts and ensure any underpayments or overpayments are corrected
  • Responds to patient and third-party payor inquiries regarding patient accounts via e-mail telephone mail and in person.
  • Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission.
  • Maintain detailed and accurate billing records for auditing purposes and compliance with industry regulations
  • Maintain thorough records of all communication with insurance providers and patients regarding claims.
  • Participate in meetings with Provider Reps to resolve denial discrepancies
  • Prepare and submit appeals for denied claims. Understanding of additional documentation necessary to submit an appeal
  • Obtain an in-depth understanding of hospice billing regulations. Ensure compliance with federal state and local billing laws including HIPAA regulations.
  • Prepare reports to managers recommending accounts for bad debt adjustments. Maintaining lost revenue at a level of less than 1% of net healthcare revenue
  • Recommends accounts for transfer to bad debt.
  • Physical Requirements

  • Ability to sit concentrate and pay close attention to detail
  • Working Conditions

  • Normal office environment with little exposure to excessive noise dust temperatures and the like
  • Conditions of Employment

    N / A

    All roles must demonstrate GBMC Values

    GBMC Values

    Value Description

    Respect

    I will treat everyone with courtesy. I will foster a healing environment.

  • Treats others with fairness kindness and respect for personal dignity and privacy
  • Listens and responds appropriately to others needs feelings and capabilities
  • Excellence

    I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.

  • Meets and / or exceeds customer expectations
  • Actively pursues learning and self-development
  • Pays attention to detail; follows through
  • Accountability

    I will be professional in the way I act look and speak. I will take ownership to solve problems.

  • Sets a positive professional example for others
  • Takes ownership of problems and does what is needed to solve them
  • Appropriately plans and utilizes required resources for various job duties
  • Reports to work regularly and on time
  • Teamwork

    I will be engaged and collaborative. I will keep people informed.

  • Works cooperatively and collaboratively with others for the success of the team
  • Addresses and resolves conflict in a positive way
  • Seeks out the ideas of others to reach the best solutions
  • Acknowledges and celebrates the contribution of others
  • Ethical Behavior

    I will always act with honesty and integrity. I will protect the patient.

  • Demonstrates honesty integrity and good judgment
  • Respects the cultural psychosocial and spiritual needs of patients / families / coworkers
  • Results

    I will set goals and measure outcomes that support organizational goals. I will give and accept help to achieve goals.

  • Embraces change and improvement in the work environment
  • Continuously seeks to improve the quality of products / services
  • Displays flexibility in dealing with new situations or obstacles
  • Achieves results on time by focusing on priorities and manages time efficiently
  • Pay Range

    $19.34 - $29.00

    Final salary offer will be based on the candidates qualifications education experience and alignment with our organizational needs.

    Equal Employment Opportunity

    GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race color religion sex sexual orientation gender identity and expression age national origin mental or physical disability genetic information veteran status or any other status protected by federal state or local law.

    Required Experience :

    IC

    Key Skills

    Medical Collection,Accounts Receivable,Athenahealth,ICD-10,Medical Coding,10 Key Calculator,Detailing,ICD-9,Medical Billing,Microsoft Excel,CPT Coding,Medicare

    Employment Type : Full-Time

    Experience : years

    Vacancy : 1

    Monthly Salary Salary : 19 - 29

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