About us
American Heart Center
Our skilled cardiology facility has an immediate need for a full-time experienced Billing Specialist who is familiar with filing insurance claims on behalf of our patients. The Billing Specialist will perform all functions required to ensure accurate and timely submission of medical claims received from providers to various health plans for expeditious reimbursement and optimal provider satisfaction. The ideal candidate will be a compassionate leader, a team player, and willing to work a problem to its successful conclusion. Previous experience is a plus and will make this transition much easier!
Roles and Responsibilities
- Distribution of claims to the payers for prompt, efficient reimbursement.
- Files paper and electronic claims
- Reports claim filing activity
- Prints, assembles and mails out claims
- Ensure claims are mailed out to payers with sufficient documentation, i.e. attachments, stamps, primary EOBs, and proper postage.
- Maintain knowledge of contract guidelines related to packaging of services for proper billing to third party administrators.
- Research and document patient encounter details related to the packaging of services.
- Report and document abnormal claim filing occurrences and provider office trends per department protocol.
- Identify and pro-actively resolve claims issues with internal and external customers.
- Obtain and retain accurate physician and contract information.
- Correct any invalid claims.
- Operate various automated data systems (Allscripts PM and Pro EHR) to obtain information, such as patient demographics, insurance information, and reports.
- Provide coverage for all essential functions of billing activities (data entry, claim filing, claim storage, claim auditing, and cross-training on package protocols per assignment).
- Completes delegated tasks as assigned
- Assist with data entry of claims: data entry of all essential components of a CMS 1500 claim form into a computerized database, perform daily reconciliation of charges entered in the database against claim reports to ensure balance, ensure claims entry turn-around requirements are met, identify and pend claims with missing or invalid information according to established protocols for investigation and resolution.
- Maintain appropriate records for area(s) of responsibility: Filing and storage of claim batches, Filing and storage of Provider Claims Transmittals in appropriate binders, Filing and storage of EOBs, medical records and other documents, Assist with preparation of files for off-site storage.
- Maintain confidentiality of all information in accordance with HIPAA.
- Maintain company confidentiality.
- Attend all regular staff meetings.
- Participate in continuing educational programs to maintain current on area of specialty.
- Work overtime, as required.
- Complete additional duties and projects as assigned by supervisor or manager.
Qualifications
- Education Required: High School Diploma or equivalency AND Coding Certification via PMI, AAPC, or AHIMA..
- Minimum 5 year’s experience in medical billing, Cardiology Office preferred
- Must have computer experience and a working knowledge of Word, Excel, electronic mail and internet.
- Candidates with a background in cardiology and/or radiology specialties are preferred.
- Experience with alpha-numeric data entry
- Excellent time management skills and an ability to prioritize and multi-task to meet deadlines
- Ability to perform assigned tasks independently
- Knowledge of medical and insurance terms.
- Experience with ICD-9, ICD-10 and CPT codes
- Experience dealing with insurance companies and managed care plans
- Neat, professional appearance and demeanor
- Ability to develop productive working relationships and work in a team environment
Job Type: Full-time/Part-Time
Job Types: Full-time, Part-time
Pay: $21.00 - $25.00 per hour
Benefits:
- 401(k) matching
- Health insurance
- Paid time off
Schedule:
- Monday to Friday
Work Location: In person
