Clinical Billing Specialist
10 hours ago
Job Title:
Clinical Billing Specialist
Location:
North Metro Knoxville, TN, USA
DescriptionThe primary function of this position is to prepare and submit claims and statements to third-party payers and guarantors.
This role is responsible for certain coding functions and maintaining accounts receivables. Benefits include eligibility for a 401(k) plan.
Schedule: PRN days, must work 4 shifts within a 6-week period.
Key Responsibilities- Process claims daily, providing all required attachments as appropriate.
- Submit all primary, secondary, and tertiary claims electronically to the clearinghouse.
- Correct unbilled claim edits as necessary to ensure accurate final billing.
- Understand and abide by all CMS billing compliance regulations.
- Familiarity with ICD9/10 and CPT/HCPCS coding, CCI edits, APCs, as well as third-party payor billing requirements.
- Append bilateral, multiple procedure, and special requirement modifiers appropriately.
- Verify accuracy of insurance payments and adjustments received/posted.
- Follow-up on insurance claims within 30 days of billing for commercial payors and 21 days for government payors.
- Respond to all billing-related inquiries and interact with patients when required to bring account to closure.
- Print and mail patient statements on a monthly basis.
- Review outstanding patient A/R on a weekly basis, identifying balances over 90 days with no payment for review with manager and potential transfer to collections.
- Submit refund requests with supporting documentation to management.
- Assist and back up other business office positions as needed.
- Answer telephone, questions, and return calls in a courteous and timely manner.
- High school diploma or GED certificate.
- Surgery center/hospital/medical office experience preferred.
- Minimum of 1 year billing experience required.
- Minimum of 1 year accounts receivable experience required.
Salary Range:
$45,000 - $65,000 per annum, depending on experience.
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