Billing Specialist I

HOURLY RATE: (DEPENDING ON SKILLS/EXPERIENCE): $21.00 - $26.14

SCOPE: Responsible for the review and/or data entry of received charges and applying appropriate coding guidelines to ensure accuracy and clean claim submission; (i.e. by assigning appropriate diagnosis codes, modifiers, splitting of claims based on DOFRs or no charging due to unbundling). Help to identify issues and report to supervisor/manager; for potential provider education, interface corrections, EPIC rules to be built or edited, etc.

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Perform timely review of assigned EPIC WQs; coding and reviewing charges by site and by date of service.
• Preview charges for billing errors and apply appropriate use and knowledge of coding guideline for various specialties to insure clean claim submission.
• Enter manual charges and apply appropriate use and knowledge of coding guideline for various specialties to insure clean claim submission
• Perform timely review of claim edit WQs to correct errors and submit clean claims
• Approve claim run as needed

MINIMUM QUALIFICATIONS:

• High school graduate or equivalent required.
• 2 year Degree preferred.
• Certificate in Medical Billing / Insurance preferred
• 2 Year Coding and posting charges in Medical Office / Hospital required.
• 1 Year EMR required.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, a calculator, telephone, copier and other such office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for prolonged periods of time.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent interaction with staff, patients and the public.