Billing Specialist

• Resolve delinquent accounts receivable across commercial, Medicare, Medicaid, and private payers
• Follow up on unpaid, underpaid, and denied claims to ensure maximum reimbursement
• Document collection activity and payer communications accurately in the EMR
• Submit adjustments and coordinate claim corrections or rebilling as needed
• Review payer correspondence and address patient or guarantor billing inquiries
• Meet departmental productivity, A/R aging, DSO, and cash collection goals
• Ensure compliance with payer requirements, SOX controls, and internal policies

• Ensure strict HIPAA-compliant confidentiality with all client data and claims
• Manage and operate in multiple different billing platforms dependent on client needs which could include Azalea, Tebra, Central Reach and/or Rethink Integrated Billing Module
• Manage assigned client accounts billing scrubs for primary and secondary claims
• Submit claims electronically for primary and secondary payors
• Solve clearinghouse rejections
• Submit corrected claims for billing errors, rebill projects (new plans/new year, new information on payor policies)
• Maintain account spreadsheets, billing cheat sheets, provider, and billing information including provider roster and payer policy billing rules
• Contribute to updates and communicate to Customer Billing Advocate and other members of POD
• Provide internal reporting to team of status and issues for clients within POD
• Meet internal benchmarks for clean claims / first pass rate, unbilled claims, clearinghouse rejections, secondary claims, and denials for billing errors
• Research specific payor billing rules as needed
• Review client billing documentation to ensure claims are submitted based on payor requirements
• Stay informed about Payor and Industry Billing rules
• Foster a positive work environment for team members

• Assist with initiating and implementing of all aspects of the monthly client billing process including: Review and edit monthly proformas as instructed by the Billing Attorney via Paperless Proforma.
• Modify time and cost entries as directed.
• Write offs and write downs.
• Completing transfers, dividing, and combining timecards.
• Ensuring rates are accurate.
• Applying available funds to billing as instructed.
• Verify accuracy of billing.
• Compile supporting back-up documentation, per client billing guidelines as required.
• Acquire and maintain proper approval documentation.
• Finalize and distribute invoices in accordance with Firm and Client guidelines.
• Research and respond to billing inquiries from both attorneys and clients in a timely and professional manner.
• Submit invoices by mail, email, e-billing via eBillingHub and other e-billing vendors as required.
• Set up matters for e-billing on vendor sites and within the firm’s billing system.
• Address and resolve billing disputes and discrepancies in a timely manner.
• Coordinate appeals for rejected invoices.
• Provide client accruals, status updates and budgets upon request.
• Communicate with attorneys, clients, or staff to address billing questions, as needed.
• Maintain contact with attorneys, staff, and clients and observes confidentiality of client and firm matters.
• Answer questions regarding billing processes and procedures.
• Collaborate with other departments as needed for Accounts Receivable, client and matter setup, rate management, trust accounting, unallocated funds, and billed on account funds.
• Maintain addresses, invoices templates, and e-billing information within the firm’s billing system.
• Assist with customized reporting requirements for internal/external clients.
• Effectively prioritize numerous tasks and complete within designated time deadlines.
• Manage monthly reports surrounding billing workload.
• Other duties as assigned.

• Responsible for two aspects of billing, collection, credit, payments, and/or reconciliations.
• Billing responsibilities include manual re-bills as well as electronic submission to payers.
• Follow-up includes telephone calls to payers and/or patients, as well as accessing payer websites, and resolving complex accounts with minimal or no assistance necessary.

Insurance Billing Representative

• Responsible for working claim errors in claims management system ensuring clean claims are submitted timely to insurance carriers.
• Review and prepare claims for manual and/or electronic billing submission.
• Reviews insurance rejections to determine the next appropriate action steps and obtain the necessary information to resolve any outstanding rejections.
• Correct and identify billing errors and resubmit claims to insurance carriers.
• Update CAS segments on secondary electronic claims as needed.
• Verifies patient demographic information and insurance eligibility including coordination of benefits; updates and confirms as necessary to allow processing of claims to insurance plans.
• Verifies receipt of claim with insurance plans, determining the next appropriate action step.
• Researches all information needed to complete the billing process including obtaining information from providers, ancillary services staff, and patients.
• Obtains and attaches referrals to appointments/charges.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Identifies and communicates trends and/or potential issues to the management team.
• Follows and maintains all HOPCo policies and procedures.

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Billing Specialist

Billing Specialist

Billing Specialist

Insurance Billing Representative

Billing Specialist