Billing Professional

The Billing Professional assists in the management of the Revenue Cycle process for their assigned payer type, provider, or location while adhering to processes and maintaining productivity and accuracy standards. This includes accurate and timely claim creation, follow-up and correspondence with providers, insurance payers and patients. Maintains data quality and integrity. Carries out all duties while maintaining compliance and confidentiality, promoting the mission and philosophy of the organization, and fostering a professional, positive work environment.

• Prepares and submits clean claims to third party payers either electronically or occasionally by paper (requested by the payer).

• Assists in identifying and resolving claim related issues.

• Denial and insurance follow-up management

• Issues adjusted, corrected and/or rebilled claims to third party payers.

• Posts adjustments transfer of responsibility and refunds accurately.

• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

• Assists with patient queries/questions.

• Communicates any issues/delays within the Revenue Cycle to the supervisor.

• Other duties as assigned.

• Stay up to date on current coding requirements.

• Work to set and achieve monthly S.M.A.R.T goals. (Specific, measurable, achievable, relevant, and time bound).

• Ensure productivity standards are met.
  
  

• Previous billing experience preferred. FQHC experience a plus

• certified coder through AHIMA (CCS-P) or AAPC (CPC) a plus

• Exhibits basic billing skills.