Entry Level Billing Specialist - In office - Clinton Twp, MI

Job Summary

Responsible for the processing  and follow up of all medical claims for services rendered to ensure proper payment to Medstar.

Essential Duties and Responsibilities:

Answer phone calls from patients and facilities. Give called accurate information in regards to their inquiry.  Conversations should be clear, concise and professional.  Use judgment to transfer any phone calls to the department manager when the caller is not understanding information, or is getting upset. 

Take payment information over the phone or via mail and forward the payment posting department for proper credit on the patient’s account.

Re-bill claims to insurances if you find errors or appealing a prior decision from an insurance company.

Follow up on open claims in a timely manner. The goal is to resolve all open claims within 90 days.

Timely posting of payments received from insurance companies, facilities, private pay and other payments received.

Posting and correcting insurance rejections in a timely manner

Process refunds by obtaining appropriate documentation, then determining the correct means of issuing the refund, either electronically or by creating a check request.

Analyze and recognize any issues with payers and report the issues timely to management for resolution.

Responsible for complete follow through with submission of electronic billing and daily acknowledgment and verification of file acceptance or rejection. This will include follow up with EDI departments to determine any issues with the file and correct and refile claims if there are errors.

Responsible for collection of assigned payers and also an assigned private pay schedule. Expectation that ongoing calls will be made to collect open balances.

Responsible to follow up on insurance appeals within 30 days of appeal.

Mail pick up

Answer customer phone call as relate to billing inquiries

Other duties as assigned

Knowledge, Skills and Abilities

High School diploma

Strong computer skills

Data Entry skills

Strong attention to detail

Working Conditions and Physical Demands

Physical Skills: Normally, assigned to work in an office environment, where there is little exposure to dust, dirt, noise, and the like. Must be able to sit for extended periods of time.  Ability to stand for long periods of time at fax machine, copier, filing cabinets. Etc.

Visual Activity: Able to see and to discriminate detail in written documents and messages from a computer screen.

Auditory Activity: Good skills to distinguish sounds like normal conversation levels.

Sensory Activity: Normal motor skills required, such as being able to type on a computer keyboard and to drive an automobile.

Verbal Activity: Ability to communicate clearly with a wide variety of employees and patients, families, co-workers, and public groups.

Other: Occasionally required to travel locally.  Reliable transportation required.