Billing & Reimbursement Specialist

McLeod Health; South Carolina; On-site; USD 38,000 - 52,000; Full time

Job summary

McLeod Health in South Carolina is seeking a Billing Specialist to manage patient accounts, submit electronic and hard copy claims, and follow up with payers to ensure timely reimbursement for services provided.

You will review remittances, resolve denials, collect patient payments, and communicate with physicians and staff to maintain accuracy and compliance with payer guidelines. Travel to off-site locations may be required.

Qualifications

• At least 3 years’ experience in a computerized physician office or hospital setting in insurance, billing and reimbursement.
• Thorough knowledge of regulations relating to Medicare, Medicaid, Worker’s Compensation, and commercial insurance.
• Demonstrates the ability to work independently and prioritize a heavy workload in a fast paced environment.

Responsibilities

• Maintain professional image and excellent customer relations with patients, visitors, physicians, and coworkers.
• Follow up on third party payers to determine why payment has not been received within a specified time.
• Review and interpret payer remittances to verify accuracy of payments and actions on denials.
• Initiate appeals for denied claims per payer guidelines.
• Submit electronic and hard copy claims accurately and timely; correct those that do not pass edits.
• Contact payers for status of unpaid claims and research to resolve issues promptly.
• Ensure timely management of claims to maximize reimbursement and resolve credit balances.
• Obtain patient payments and set up payment plans; prepare accounts for collections if needed.
• Understand processes for corrected claims and maintain knowledge of payor guidelines.
• Travel may be required to off-site locations.

Skills

Customer service

Communication

Attention to detail

Time management

Education

High School Diploma/GED

Tools

Microsoft Word

Outlook

Excel

Job description

McLeod Health in South Carolina is seeking a Billing Specialist to manage patient accounts, submit electronic and hard copy claims, and follow up with payers to ensure timely reimbursement for services provided.

You will review remittances, resolve denials, collect patient payments, and communicate with physicians and staff to maintain accuracy and compliance with payer guidelines. Travel to off-site locations may be required.