Senior Medical Billing & Claims Specialist

Brown University Health; Providence (RI); On-site; USD 30,000 - 50,000; Full time

Job summary

Brown University Health is seeking a Sr Billing Specialist to perform patient account review against insurance specifications and coding review. You will research high-dollar claims and denials, resolve patient billing inquiries, and follow up on balances due from insurance companies, involving ICD-10 and CPT codes.

The role operates in a physician office practice billing environment, with standard hours and a daytime shift.

Qualifications

• High school level knowledge or equivalent.
• Experience with CPT4, ICD-9/10, HCPCS, coding guidelines and reimbursement policies/procedures.
• 4+ years’ experience in a fast-paced medical office or billing service environment with third-party billing familiarity.
• Thorough knowledge of medical billing, claims processing, customer service, medical terminology, and basic PC use.
• Familiarity with CPT, ICD-10 coding and hospital billing terminology.

Responsibilities

• Researches and investigates high-dollar claims and denials from third-party payers and resolves patient billing inquiries.
• Reviews patient accounts against insurance program specifications and verifies information.
• Follows up on payer claims denials to ensure proper re-processing.
• Analyzes and resolves coding issues using ICD-10 and CPT codes.
• Reviews documents to ensure correct information and coordinates with other departments to resolve errors.
• Obtains and verifies patient registration information and completes registration accurately.
• Responds to patient billing inquiries in a timely, courteous manner.
• Keeps current with billing guidelines.
• Performs other related duties as assigned.

Skills

CPT4

ICD-9/10

HCPCS

Coding guidelines

Reimbursement policies

Customer service

Medical terminology

Critical thinking

Education

High school diploma or equivalent

Tools

Basic computer skills

Job description

Brown University Health is seeking a Sr Billing Specialist to perform patient account review against insurance specifications and coding review. You will research high-dollar claims and denials, resolve patient billing inquiries, and follow up on balances due from insurance companies, involving ICD-10 and CPT codes.

The role operates in a physician office practice billing environment, with standard hours and a daytime shift.