Billing and Reimbursement Specialist

POSITION SUMMARY:

The Billing/Reimbursement Specialist is a member of the business office team whose responsibilities are correcting, completing and processing claims of all payer codes timely. The individual is also responsible for charge entry, payment posting, and claims follow-up/appeals.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Remain up to date on all changes or adjustments in billing procedures established by each individual contracted payer and inform Revenue Cycle Manager of all updates.
• Review claims for accuracy and update any missing information prior to submission to avoid rejection.
• Follow up with insurance companies and monitor delinquent filed claims per established department guideline.
• Call insurance companies regarding any discrepancy in payments, when necessary.
• Identify and bill secondary or tertiary insurances.
• Cross train and cover for Billing/Reimbursement Specialist peers.
• Prepare month end close out and submit all necessary information to the accounting officer or place in the designated file for review.
• Seek training, experiences, and associations with professional groups to acquire and maintain skills necessary to fulfill professional responsibilities.
• Attend monthly meeting as required.
• Assist Business office manager as needed.
• Provide support and assistance to front staff as needed.
• Additional Duties as assigned.

QUALIFICATIONS:

• Education Level: High School diploma or equivalent. Associate degree in Business Administration, Accounting or Health Care Administration, preferred.
• Experience Years: 2-4 years of related experience in the Healthcare industry (Pediatric Preferred).
• Strong background in processing Medicaid claims (2-4 years of experience).
• Certification in Professional Coding (CPC) is preferred.
• Equivalent combination of relevant education and experience will be considered.
• Electronic Health Record System: Knowledge in eClinicalWorks.

SKILLS:

• Knowledge of medical terminology, billing practices and payer codes.
• Ability to communicate effectively both in written and verbal formats.
• Organized and detailed oriented skills.

REQUIREMENTS:

• Employee must have proof of COVID-19 vaccination record.
• Work Location: Business Office.

Job Type: Full-time

Pay: $20.00 - $23.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off

Education:

• High school or equivalent (Preferred)

Experience:

• Medical terminology: 2 years (Required)
• Medical billing: 2 years (Required)

License/Certification:

• Certified Professional Coder (Preferred)

Ability to Relocate:

• Houston, TX 77065: Relocate before starting work (Required)

Work Location: In person

Salary : $20 - $23