Physician Commercial Billing Specialist — Full-Time with Benefits

Wilson-Health; Buckeye Terrace (OH); On-site; USD 30,000 - 41,000; Full time

Benefits offered by this job

Free on-site clinic access

Generous PTO

HDHP/PPO options with insurance

Employer HSA contribution

Life Insurance

Long-Term Disability Insurance

Retirement plan with company match

Tuition Assistance

On-site gym access

Employee discounts

Job summary

Wilson Health in Sidney, OH is seeking a full-time Commercial Physician Billing Specialist. The role releases commercial payer claims electronically and mails 1500 claims as needed, with follow-up on unpaid claims and appeals as required.

The position reports to the Manager of Patient Accounts and requires prior physician billing experience and familiarity with payer requirements and EHR systems. Excellent attention to detail and communication are essential.

Qualifications

• High school diploma or GED required.
• Minimum of one year of prior physician billing experience.
• Experience with Epic or other EHR and patient accounting systems.
• Experience using Microsoft Excel.
• Familiarity with commercial payer requirements, professional billing, claim denials, and appeals.

Responsibilities

• Billing of claims through Electronic Vendor (Quadax) which requires keeping up to date with payer requirements and edits.
• Bills secondary, tertiary, etc., claims electronically or mails the 1500 with EOB as required by the payer.
• Monitors claims using various payer portals.
• Works closely with all physician groups and staff regarding charges and/or late charges.
• Appeals claims on behalf of the patient to secure payment, or if a claim has been denied for inappropriate reasons.
• Follows up on appeals; works mail as it applies to the Commercial Professional Billing Specialist to secure payment.
• Works closely with physician groups and staff, and Medical Records regarding denials for no authorizations and/or medical necessity to secure documentation and/or diagnosis to submit a corrected claim or appeal.
• Works underpayment records daily to ensure proper payment from payers and makes appropriate adjustments as required.
• Submits documentation to the Professional Supervisor or Manager of Patient Accounts for refunds.
• Receives calls from patients regarding balances, itemized bills, or EOBs.

Skills

Prior physician billing experience

Billing knowledge

Education

High school diploma or GED

Tools

Epic EHR

Microsoft Excel

Job description

Wilson Health in Sidney, OH is seeking a full-time Commercial Physician Billing Specialist. The role releases commercial payer claims electronically and mails 1500 claims as needed, with follow-up on unpaid claims and appeals as required.

The position reports to the Manager of Patient Accounts and requires prior physician billing experience and familiarity with payer requirements and EHR systems. Excellent attention to detail and communication are essential.