What are the responsibilities and job description for the Specialist-Insurance Billing position at Spartanburg Regional Healthcare System?
Job Requirements
Position Summary
The Insurance Billing Specialist is responsible for a range of billing processes related to managing the ready to bill unbilled revenue. This position is responsible for the timely and accurate billing of all patient accounts to meet and/or exceed our departmental goals for cash collections and AR.
Minimum Requirements
Education
Preferred Education
Position Summary
The Insurance Billing Specialist is responsible for a range of billing processes related to managing the ready to bill unbilled revenue. This position is responsible for the timely and accurate billing of all patient accounts to meet and/or exceed our departmental goals for cash collections and AR.
Minimum Requirements
Education
- High School Diploma or equivalency
- Must have had at least 4 years electronic billing and/or billing editing experience in a hospital and/or physician office setting.
- General Knowledge of HCPCS, CPT-4 and ICD9-10 coding and/or medical terminology.
- Familiar with multiple payer requirements and regulations for claims processing
- Solid Microsoft Office skills required.
- Good communication skills and the ability to courteously interact with multiple departments within SRHS
- N/A
Preferred Education
- Healthcare related Associates or Bachelor’s degree
- 5 years billing experience in a hospital and/or physician billing setting.
- Experience in billing both technical and professional charges.
- Experience with DDE
- Certified Revenue Cycle Associate (CRCA)
- Certified Professional Coder- Hospital Services (CPC-H)
- Responsible for all pre-bill edits and claim scrubber edits for accuracy and compliance with all government and commercial carriers billing guidelines before releasing for submission to payers.
- Understands and adheres to state and federal regulations and system policies regarding compliance, integrity and ethical billing practices.
- Must possess a good working knowledge of the UB04 and CMS 1500 claim forms and the data elements/field data required
- Responsible to bill all services within timely filing as defined by departmental goals and insurance guidelines.
- Must understand and comply with the rules regarding edits.
- Responsible for all billing related denials to identify trends to improve clean claim rates
- Responsible for multiple daily reporting of billing indicators through various reporting tools
- Must be able to accurately complete review and resolve all combined billing requirements to ensure compliance.
- Responsible to work all referrals within a 24/48-hour turnaround time from receipt.
- Exhibit good professional communication and customer service skills at all times while working with coworkers and employees in multiple departments within the system.
- Other duties as assigned