Position Overview:
Our Billing Specialists are responsible for answering patient inquiries, reviewing outstanding or denied insurance claims, submitting insurance appeals, and maintaining assigned accounts receivables per clinic policies.
Essential Duties & Responsibilities:
Assist in the processing of insurance claims including worker’s compensation (if assigned) for all financial classes
Communicate with insurance companies to ensure that claims are paid; identify and correct account and/or insurance error; and post all actions and maintain permanent record of patient accounts
Oversee claims appeals and reviews; review claims aging status and follow up on open claims
Answer patient questions, inquiries, and concerns regarding their accounts; verify balances and refunds for accuracy
Understand, and stay up to date with, clinic and insurance industry contract policies/ procedures and medical terminology
Participate in professional development efforts to stay current with health care best practices and trends
Actively participate in the company’s efforts to create innovative data and analytics solutions for the modern orthopedic business office
Other duties as assigned
Required Skills:
High school diploma or equivalent, college courses or certificate preferred
Excellent communication skills, especially phone skills, that encourage the establishment and maintenance of cooperative, positive relationships with both internal and external stakeholders (patients, physicians, colleagues, etc.)
Ability to efficiently gather, organize, and comprehend insurance information, including contracted fee schedules
Proficient computer skills with a demonstrated ability to navigate and comprehend computer software systems in an office setting, prefer 50wpm typing skill
Knowledge of, or a demonstrated capacity to learn, insurance industry practices and medical terminology in a clinic setting
Strong analytical skills and a demonstrated desire to be part of building innovative solutions that challenge the status quo
Ability to learn quickly and contribute ideas that make the team, processes, and solutions better
Share our values: resilience, altruism, communication, achievement, and determination
Preferred Skills:
Two years of billing experience in a hospital and/or surgical setting
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