Billing Specialist

• Coordinates and facilitates patient billing and collection activities
• Processes payments, adjustments, claims, correspondence, refunds, denials, financial/charity applications
• Researches payments, denials, and accounts
• Builds strong working relationships with assigned business units

PFS Representative, CBO Billing, Follow-up, Denials Management

• Collects, posts, and manages patient account payments.
• Prepares and reviews patient statements.
• Imports and balances EFT’s.
• Identifies and corrects rejected claims.
• Reviews delinquent accounts and contacts for collection purposes.
• Verifies patients’ insurance coverage.
• Answer questions regarding billing and insurance policies.
• Process payments from insurance companies.
• Follows up to see if a claim is accepted or denied.
• Reviews and appeals unpaid and denied claims accordingly.
• Evaluates medical record documentation to ensure proper CPT and ICD-10 codes are billed appropriately.
• Obtains precertification, if required, for specific procedures.
• Investigates insurance fraud and reports if found.

Billing and Coding Associate

• Contact third party payers to verify eligibility, obtain claim status and take steps to properly resolve CMS 1500/837P claims
• Utilize various internal and online follow up tools provided by Westerkamp Group, LLC and our clients to resolve accounts
• Critically analyze account balances, Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), denial reason codes (CARC), and remittance advice remark codes (RARC) on CMS-1500 /837P claim forms to determine the root cause of denials
• Maintain workqueues and track trends that can be escalated to management
• Clearly notate accounts per Westerkamp Group or client specific standards
• Review paper correspondence and take necessary action to resolve insurance payer requests
• Analyze and submit cash posting payment and contractual adjustment errors
• Adhere to strict compliance guidelines related to HIPAA

Billing Insurance Follow Up Analyst

• Supports the complete and timely collection of revenue for assigned groups by performing accurate coding and entry of patient and charge information into the billing system.
• Tracks all high dollar claims from charge entry to payment and resolves complex carrier issues.
• Actively follows up on outstanding complex claims/or charges.
• Reviews and resolves complex issues that result in payer denials, including appeals, coding corrections, medically necessity rules and other related functions.
• Assists the auditor in reviewing notes for medical necessity.
• Works with the authorization department to resolve authorization issues with complex procedures.
• Runs and maintains tracking logs to track complex high dollar procedures and report the results to the billing department management team.
• Contacts the various Provider Service Representatives to resolve repetitive payment issues.
• Acts as a resource for the Billing Staff for complex issues.
• Analyzes and resolves billing issues, keeping A/R to no more than 10% over 60 days.
• Processes daily correspondence, claim status, handle denials, appeals and re-bills.
• Answers billing questions and inquiries from patients and internal staff.
• Updates patient files with address changes, contact information changes, etc., as needed.
• Reviews all policy changes on a regular basis and informs supervisor and charge entry specialist of such changes.
• Efficiently navigates assigned insurance companies' proprietary websites to find policies, research payments, etc.
• Keeps supervisor apprised of matters regarding accounts receivable.
• Responds to requests from billing company in a timely fashion.
• Researches denials and submits correct claims/medical documentation.
• Reviews and manages claims within the work dashboard hold buckets for resolution.
• Creates, maintains and updates reports, as directed.
• Exercises confidentiality in all areas, abiding by HIPAA rules and regulations.
• Helps train new revenue cycle staff.
• Collects and reviews end of day reports.
• Checks work e-mail on a regular basis throughout the workday.
• Participates in and completes all required trainings and in-services.
• Performs other duties as assigned.

Billing Specialist jobs in Alabama

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PFS Representative, CBO Billing, Follow-up, Denials Management

Billing and Coding Associate

Billing Insurance Follow Up Analyst

Billing Specialist II