Billing Review Specialist

This employee ensures that all assigned reviews and company projects are completed timely and accurately according to the scope of work. They will report any issues and/or concerns timely to the Supervisor of the Centralized Billing Review team and/or Manager of the Centralized Billing Review team.
JOB FUNCTIONS

• Contacts payors at times to discuss policy criteria or to ask clarifying questions on accounts
• Understands payor requirements according to their policies
• Ensures completion of all forms and collects complete billing information
• Pursues, maintains, and communicates medical coverage/guideline changes/updates
• Verifies insurance benefits and eligibility for patients
• Communicates with patients to resolve billing issues and ensures timely payment
• Maintains accurate and up-to-date patient records in compliance with HIPAA regulations
• Works assigned reports accurately and timely
• Helps facilitate interoffice communication on payor updates and trends
• Completes any adjustments/transfers of AR as required
• Documents all activity in customer's computer account or applicable applications
• Answers billing review specialist questions accordingly
• Reports issues and/or concerns in a timely manner
• Available to assist other billing review specialists on the team with questions or needs
• Acts as liaison between staff and management

Qualifications Education

• High School Diploma or General Education Degree (GED) Required

Knowledge, Skills, and Abilities

• Past performance shows solid evidence of insurance qualifications and guidelines
• telephone etiquette and adequate oral and written communication
• Shows effective multitasking
• Positive and cooperative attitude in working and communicating with individuals at all levels of the organization
• medical field experience preferred