The Claims Billing Specialist is responsible for responding to inquiries related to claims, eligibility, and authorization and working with multiple parties to ensure records are up to date. Ensures accuracy, reports issues and works to resolve. Ensures compliance and regulatory guidelines and health plan requirements are met. Documents actions taken following HIPAA guidelines. May assist in providing customer service, member services, and others in working with providers/billing offices when needed. Performs other duties as assigned.
Billing Specialist only
May also maintain databases, audit information and works with patients to process patient payment. May follow up with insurance companies on outstanding or unpaid claims, create/send statements to patients.
Proficient in Microsoft Word, Excel, Typing/Data Entry
Experience in and knowledge of all medical billing protocols including HCPCS, ICD-10, and CPT codes as well as EMR system experience.
High School Diploma or equivalent, 1+ years of experience in medical claims/billing