PhyNet Dermatology has an IMMEDIATE NEED for the top Billing Specialists to join our team! If that’s you, we invite you to apply to today! The Billing Specialist I is responsible for all aspects of insurance follow up and collections, including making telephone calls and accessing payer websites.
- Monitor commercial, government, and specialty payer claims to ensure timely follow up and claims resolution.
- Maintain working knowledge of all payer guidelines and requirements as they relate to denials and appeals.
- Make changes to demographic information as necessary to produce a clean claim.
- Meet or exceed productivity standards in the completion of daily assignments and accurate production.
- Responsible for reviewing and understanding medical records, provider notes, Explanation of Benefits, etc. for knowledge of appeal or account resolution.
- Facilitates and initiates appeals to insurance companies for claim resolution.
- Handles correspondence requests from payers to ensure all information that is required for claim processing is provided in a timely manner.
- Analyze coding to ensure proper billing of claim. Experience with claims follow up, denial posting, claim processing, and appeals.
- Adhere to quality and productivity standards assigned by management.
- Ensure statements are generated for the patient responsibility amounts.
- Utilize insurance websites to view and resolve claims.
- Perform extensive account follow-up and provide analysis of problem accounts.
- Document all follow up efforts in a clear and concise manner into the AR system.
- Audit and research accounts, payment and contractual postings, and patient payments to confirm the accuracy of the balance of the account.
- Ability to identify and report payer trends that may provide insight into payment challenges. Collaborate with management on difficult or reoccurring denials.
- Phone contact with patient, physician office, insurance company, etc. for additional information to process the claim.
- Ability to assign CPT/ICD-9/10 and HCPCS codes from surgical/progress note.
- Attention to detail with the ability to identify/resolve problems and document the outcome.
- Regular and reliable attendance.
- Strong telephonic communication skills with a pleasant and friendly demeanor.
Join us if you have:
- Global denials/follow up experience REQUIRED!
- Ability to review, comprehend, discuss HCFA billing with Insurance or Government agencies.
- Knowledge of general insurance requirements, working denials, and submitting appeals.
- Experience working directly with EOBs and contractual adjustments.
- General computer knowledge, working with electronic filing.
- Ability to communicate verbally/in writing with professionalism.
- Ability to meet productivity expectations