|Job Title||Follow up Billing Specialist|
|Department||Front End Billing|
Under the supervision of the Administrative Billing Supervisor, the Billing Specialist is responsible for billing follow-up on unpaid claims. This includes performing assigned duties and responsibilities for the timely and consistent follow-up on outstanding accounts receivable balances with patients/guarantors.
PRIMARY RESPONSIBILITIES AND DUTIES
The following essential duties and responsibilities are not all inclusive. Other responsibilities and duties may be assigned.
- Receive and work daily assignments for follow-up through work queues and reports.
- Appeals or corrects claims in a timely manner to avoid past filing limit write-offs.
- Monitors for and reports trends on denied claims.
- Properly prepares claims for re-submission.
- Make outgoing calls for assigned accounts to insurance payors and patient/guarantors to resolve accounts.
- Reports quality and documentation issues to the Administrative Billing Supervisor immediately.
- Keeps up to date on all insurance laws and procedures, (i.e. Government Programs, Medicaid, Medicare, Private and commercial Third Party Payers) to insure that billing and collection practices are legal.
- Assists Management team with ambulance front-end data problems in order to avoid denied claims.
- Participates in Committees, special projects, and all other duties as assigned.
- Verify all demographic and insurance information is complete and correct for each bill and obtain any missing information. Utilization of various electronic verification systems, Gateway, Web Denis, Medicare Eligibility, and Internet based sites.
- Data entry
- Adheres to department customer service and performance standards.
- Follows up with third-party insurance carriers on unpaid claims till claims are paid
- Be willing to take all effective avenues to get denied or delayed claims processed efficiently
- Complies with HIPAA policies and procedure
- Process adjustments to accounts in accordance with written policies.
- Request itemized statements as needed.
- All other job duties as assigned.
This position has no responsibility to manage or lead a team.
EDUCATIONAL AND CERTIFICATION REQUIREMENTS AND WORK EXPERIENCE
- Minimum Education: High School Diploma or equivalent.
- Minimum Work Experience: One to two years billing experience.
- Certification, Licensure, Registration: None required. Billing Certificate Preferred.
KNOWLEDGE AND SKILLS REQUIRED
- Contacts with Others: Works closely with Coders, Refund Specialists, Clerical Support, Customer Service Representatives, Modifiers, Management Team, and Insurance Payers. As a member of the Parastar team, works collaboratively with all other team members towards meeting the goals of the organization.
- Analytical Demands: Must be able to work effectively with available computer systems. Must have the ability to organize work activities to ensure efficient use of time and acceptable productivity.
- Physical Effort: Mental/visual stress related to viewing of computer screens and printed material for prolonged periods. Lifting limited to a box of forms weighing 7-8 pounds. Prolonged periods of sitting.
- Work Environment: Normal office environment with limited exposure to health or accident hazards.
- Equipment Used: Computer, telephone, collection system, printer, calculator, typewriter, fax machine, and copy reproduction equipment.
Community EMS utilizes Direct Deposit for compensation. As a condition of employment, all employees must designate a financial institution equipped to accept direct deposits and the number of the account into which the deposit is to be made.