Billing Specialist

Family Health Centers of Southwest Florida; Fort Myers (FL); On-site; USD 42,000 - 54,000; Full time

Job summary

Family Health Centers of Southwest Florida is seeking a Billing Specialist to manage the timely and accurate billing of provider services using CPT, HCPCS and ICD-10 codes. You will submit clean claims to Medicare, Medicaid, and commercial carriers and resolve rejections.

Responsibilities include reviewing claim data, entering charges, filing claims with payers, and addressing self-pay collections while maintaining HIPAA compliance and working with an EHR system.

Qualifications

• Knowledge of Medicaid, Medicare, and Commercial Insurance rules.
• Familiarity with CPT, HCPCS and ICD-10 coding and modifiers.
• Understanding of HIPAA guidelines.

Responsibilities

• Submits claims to payers according to guidelines.
• Reviews information for claims accuracy (patient data, codes, modifiers).
• Enters charges accurately for fast payment.
• Files claims timely with clearinghouse or payers.
• Corrects claim edits within 24 hours of receipt.

Skills

Attention to detail

Multi-tasking

Interpersonal communication

Data entry

Problem-solving

Education

High School diploma or equivalent

Associates degree preferred

Tools

EHR systems (Intergy)

Microsoft Excel

Alpha-numeric data entry

Job description

POSITION DESCRIPTION

The Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients and works rejections.

Description

The Billing Specialist is responsible for timely, accurate and comprehensive billing of all provider services utilizing appropriate CPT, HCPCS and ICD-10 diagnosis codes. The individual prepares and submits clean claims to Medicare, Medicaid, Commercial insurance carriers, and Self-Pay patients and works rejections.

Duties And Responsibilities

• Submits claims to payers based on review of medical records and in accordance with Medicare, Medicaid, and Commercial insurance guidelines as well as FHCSWF policies and procedures.
• Reviews information necessary for insurance claims such as patient, insurance ID, diagnosis and treatment codes and modifiers, and provider information to ensure clean claim submission.
• Enters charges accurately and expeditiously to ensure proper records handling and fast payment.
• Timely filing of insurance claims to clearinghouse or individual insurance companies electronically or via paper.
• Review and correction of claim edits within 24 hours of being received from clearinghouse and internal claims scrubber.
• Initiates private pay collections after insurance cancellation, denial or other issue and answer patient questions on patient responsible portions, copays, deductibles, write-offs, etc.
• Performs self-pay patient billing.
• Prepares and sends patient statements for charges not covered by insurance.
• Other duties as assigned.

Requirements

KNOWLEDGE

• Demonstrated knowledge of Medicaid, Medicare, and Commercial Insurance rules and procedures in a managed care plan environment
• Medical terminology, CPT, HCPCS and ICD-10 coding and modifier usage
• Understanding of FQHC billing procedures and Sliding Fee Schedules a plus
• EHR systems expertise, preferably with Intergy or other ambulatory care facility-based system
• Understand and adhere to all HIPAA guidelines
• MS Office Suite (Excel proficiency)
• Alpha-Numeric data entry

Skills And Abilities

• High School or Equivalent (Associates Degree preferred)
• 2 Years Medical Billing experience
• CMRS, CPB, or CPC credentials a plus
• Attention to detail with strong documentation, analytic and problem-solving skills
• Ability to multi-task in a fast-paced environment
• Strong interpersonal written & verbal communication skill