Medical Billing Specialist: Claims, Payments & Inquiries

Tandemhealthsc; Sumter (SC); On-site; USD 38,000 - 58,000; Full time

Job summary

Tandemhealthsc is seeking a Billing Specialist to join our Sumter, SC team. You will review claims for completeness and accuracy, stay current on billing guidelines, and assist patient inquiries about billing issues.

Responsibilities include follow-up on submitted claims, resubmitting as needed, handling PROREVIEW and prompt pay worklists, and creating Good Faith Estimates for patient appointments. Education: high school diploma required; associate or bachelor's in a related field or 2+ years

Qualifications

• High school diploma required; associate's or bachelor's degree in a related field, or at least two years of billing and coding experience preferred.

Responsibilities

• Reviews all claims for completeness and accuracy and makes the necessary corrections.
• Stays current on all billing guidelines.
• Researches and responds by telephone and in writing to patient inquiries regarding billing issues and problems.
• Follows up on submitted claims; monitors unpaid claims; resubmits claims as necessary.
• Works assigned insurance and patient HOLD buckets in Athena
• Works PROREVIEW worklist (prompt pay)
• Creates Good Faith Estimates for patient appointments
• Keeps supervisor informed of problems or potential problems.
• Completes other duties as assigned by supervisor.
• Assists with other special projects as assigned by management, such as: Processing credit card payments from insurance companies, Completing retroactive sliding fee claims, Applying patient payments to accounts, Tracking provider errors to ensure accurate charting, Answering patient questions in Athena Billing Portal Inbox, Completes Bad Debt review monthly

Skills

Billing and coding experience

Education

Associate's/Bachelor's degree in a related field

Two years billing and coding experience preferred

Tools

Athena Billing Portal

Job description

Tandemhealthsc is seeking a Billing Specialist to join our Sumter, SC team. You will review claims for completeness and accuracy, stay current on billing guidelines, and assist patient inquiries about billing issues.

Responsibilities include follow-up on submitted claims, resubmitting as needed, handling PROREVIEW and prompt pay worklists, and creating Good Faith Estimates for patient appointments. Education: high school diploma required; associate or bachelor's in a related field or 2+ years