Billing Specialist

Job Title: Billing Specialist

Department: Billing

Reports to: Revenue Cycle Manager

Location: Arlington, TX

Employee Type: Full-Time

FLSA Status: Non-exempt - Hourly

Summary: The billing specialist is responsible for coordinating patient and insurance billing for our multi-specialty orthopedic group and providing patient care excellence by performing the following duties:

Essential Duties and Responsibilities include the following:

• Responsible for following entire revenue cycle from charge entry through insurance and patient payments.
• Work through an electronic claims worklist to follow up with insurance companies to investigate status of claims. Appeal denials, resubmit claims, send medical records and process any additional information as needed.
• Work in partnership with Athena to ensure claims have processed correctly and payments have been posted correctly.
• Answers telephone, and responds to inquiries from insurance carriers, patients and co-workers.
• Investigate and resolve billing discrepancies resulting in overpaid/underpaid accounts.
• Establishes payment plans to help patients manage payment of bills.
• Confers with doctors, nurses, and other health personnel to assure complete, current, and accurate medical records.
• Operates computer to process, store, and retrieve health information.
• Communicate any trends, discrepancies and underpayments to the Revenue Cycle Manager immediately.
• Submit refunds for processing by the Revenue Cycle Manager.
• Other duties may be assigned.

Supervisory Responsibilities

This job has no supervisory responsibilities.

Education and/or Experience

High school diploma or general education degree (GED). Two to three years related experience and/or training; or equivalent combination of education and experience a must.

Skills and Abilities

Strong computer skills

Working knowledge of commercial and government insurance

Effective communication skills

Ability to work independently and as part of a team

Other Qualifications

Previous medical billing and surgery billing experience required

Prior customer service representative experience requird 

Experience with billing program software, Athena, preferred  

Knowledge of ICD-10, CPT, HCPCS codes and documentation guidelines required