Billing Specialist (GMG)

Healthcare Staffing; Northpointe Hall (TN); On-site; USD 35,000 - 50,000; Full time

Job summary

Healthcare Staffing is seeking a dedicated individual to join their Physician Billing Department. The role focuses on billing accurate information to government and commercial payers, ensuring compliance, and addressing patient inquiries with professionalism.

Candidates should have a high school diploma and at least two years of experience with PCs. Knowledge of medical terminology and skills in Excel and Word are essential.

The work environment is busy, requiring strong communication and time-management skills.

Qualifications

• Minimum 2 years experience with PCs/computers.
• Ability to concentrate with frequent interruptions.
• Experience using Excel and Word or equivalent applications.

Responsibilities

• Bill accurate information to government and commercial payers.
• Work with payers to resolve problems for timely reimbursement.
• Ensure compliance with Medicare and other insurance carrier guidelines.

Skills

Attention to detail

Strong communication skills

Effective time management

Medical terminology knowledge

Education

High school graduate or equivalent

Tools

Excel

Word

Job description

Position Details

Work Shift: Day Shift (United States of America)

Scheduled Weekly Hours: 40

Department: Physician Billing Dept

Overview

Bills accurate information to government and/or commercial payers according to established guidelines and government regulations. Serves as coordinator for GMG billing by performing and directing duties that process bills related to government payors according to governmental regulations. Coordinates and works with other departments, payors, attorneys, patients as appropriate and others as necessary to ensure correct information is billed. Responds to patient inquiries in a responsible, professional and caring manner for quality customer satisfaction.

ESSENTIAL DUTIES

• Bills accurate information to government and commercial payers according to established guidelines and government regulations.
• Works with payers as necessary to resolve problems resulting in correct and timely reimbursement.
• Works rejections/denials and work lists in a timely manner to prevent write‑offs.
• Works with the coding and credentialing department to realize and correct denial patterns and to ensure optimum reimbursement.
• Reconciles monthly banking logs with Accounting.
• Reconciles daily office posting to Epic and shares information with appropriate practice managers.
• Responds to patient inquiries and concerns in a responsible, professional and caring manner for quality customer satisfaction.
• Demonstrates understanding of reimbursement systems including ICD & CPT required.
• Plans & coordinates all activities regarding third party billing.
• Ensures compliance with Medicare and other insurance carrier guidelines related to documentation.
• Responsible for filing medical claims and follow up on pending and problem claims on a timely basis.
• Communicates with patients and insurance companies as needed regarding insurance issues.
• Ensures all electronic claims submissions and electronic reimbursement issues are addressed by working with vendors and/or information systems.
• Data entry of charges with verification of proper ICD and CPT codes – specific knowledge of coding applications.
• Posts personal and insurance receipts.
• Performs verification, pre‑certification and referrals of scheduled surgeries.
• Assists as collection coordinator, answer billing questions and set up payment arrangements.

QUALIFICATIONS

• High school graduate or equivalent.
• Minimum 2 years experience with PC’s/computers.
• Knowledge of medical terminology.
• Experience using Excel and Word or equivalent applications.
• Effective time management and organization skills.
• Attention to detail, strong communication skills and effective listening.
• Ability to concentrate with frequent interruptions.

WORKING CONDITIONS / PHYSICAL REQUIREMENTS

• Work is performed in an office environment.
• Work may be stressful at times due to a busy office.
• Interaction with others is constant and interruptive.
• Employee is required to stand, walk, talk, hear, use hands and arms regularly.
• Employee must regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds.

Genesis is committed to being an equal opportunity employer. Selection of applicants for employment is based only on qualifications and the requirements of a specific job.