Job Title: Surgical Facility Billing Specialist

Reports to: Finance Manager

GENERAL SUMMARY OF DUTIES: The Surgical Facility Biller is responsible for billing all diagnosis and procedures with proper codes. The Biller is responsible for record maintenance, daily charges and preparing and submitting claims to the payers. The Biller will work collaboratively with the central billing office, surgical facility staff and accounting team. The Biller will process adjustments, credit balance review and audits when needed. The Biller will verify insurance and calculate patient responsibility.

Essential Job Functions:

• Ensures that all scheduled or performed cases are accounted for and billed
• Assigns diagnosis and procedure codes for each case
• Verifies accuracy of insurance payments and adjustments received/posted
• Prints and mails patient statements on a frequent basis
• Submits insurance and patient bills
• Posts refunds on accounts
• Processes claims electronically or by mail
• Monitors logs to ensure claims were submitted and received properly, and follows up with insurance companies to ensure receipt of bills
• Reviews and corrects rejected claims and re-bills in a timely manner
• Maintains charge entry on a daily basis
• Reviews and processes contractual adjustments
• Responds to all billing related inquiries and interacts with patients when required to bring account to closure and make financial arrangements
• Answers telephone and returns calls in a timely manner
• Verifies Insurance and calculates patient responsibility
• Processes patient payments daily
• Additional duties as assigned by the Manager to meet department needs.

Requirements:

• Minimum of 2 years’ experience in a physician/medical office, ambulatory surgery center, or hospital business office environment in billing required
• CPC certification preferred, but not required
• Strong CPT and ICD-10 knowledge, aging and collection processing
• Orthopedics surgical billing experience preferred
• Ability to work independently but also a team player; offers team member support and guidance
• Interpersonal skills to deal effectively with patients, physicians and staff
• Strong organizational skills
• Ability to follow collection account to a successful conclusion
• Knowledge of third-party billing and other collection skills