Medical Billing Specialist

Description

Company Overview: USPI was founded in 1998 with a promise to deliver high-quality, lower-cost solutions in our communities. Today we are the largest ambulatory surgery platform in the country, with more than 500 surgical facilities. We are also part of Tenet Healthcare, a unique and diversified enterprise which enables us to have access to additional resources and a greater support system. 

Position Overview: 

Reporting to the Billing Supervisor, Level 2 Billers are responsible for the daily entry of charges for their assigned surgical centers. This will include but is not limited to the following: assign modifiers, diagnosis codes, and revenue codes according to reimbursement guidelines resulting in claim reimbursement.

Responsibilities: 

• Act as a resource for all critical aspects of the CBO which includes liaising between departments as well as assisting Level 1 Billers.
• Execute the recurring billing workflow and generate and transmit to designated electronic claims clearinghouse daily.
• Work DNFB, Hold Timeline Report and Late charges for assigned facilities.
• Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.
• Edit Failures, Coding Updates, answer facility emails as well as CSO departmental emails, and billing as needed.
• Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, invoices, or implant pricing, etc.)
• Reconcile revenue and billing during the month end close process.
• Maintain current knowledge of health care billing laws, rules, and regulations and developments.
• Help with reports/special projects as needed and other duties as assigned in accordance with priority.

Requirements

• One year’s previous experience or some hospital clerical experience or medical terminology preferred.
• Understanding of Medical Terminology
• Basic understanding of billing guidelines and laws
• Must demonstrate a positive demeanor, good verbal, and written communication skills, and be professional in both appearance and approach.
• Must be able to handle potentially stressful situations and multi-task and handle competing priorities while meeting or exceeding deadlines.
• Knowledge or experience working with a variety of health care insurance payers preferred.
• Any of the following: Cerner, nThrive, Advantx, Waystar, Meditech, and/or EffecientC experience preferred.
• Must have Intermediate computer proficiency in Microsoft Office including Excel and Outlook.
• High school graduate or equivalent.