Sr. Billing Specialist

Brown Medicine; United States; Sur place; USD 30 000 - 50 000; Plein temps

Résumé du poste

Brown University Health is seeking a Sr Billing Specialist to verify patient accounts, review insurance program specifications, and resolve high-dollar claims and denials. You will work with departments to ensure accurate billing and compliance with ICD-10 and CPT coding, while supporting patient inquiries and policy updates.

The role emphasizes professionalism and adherence to the organization’s values, with standard office hours in Providence, RI.

Qualifications

• High school level of knowledge or equivalent.
• 4+ years’ experience in a fast-paced medical office or billing service environment.
• Experience with CPT4, ICD-9/10, HCPCS and coding guidelines.
• Analytical ability to research and resolve billing problems and to analyze billing activity.

Responsabilités

• Research claims in system and verify patient account information against insurance specifications.
• Follow up on payer claims denials and ensure proper re-processing of rejected claims.
• Analyze and resolve coding issues using ICD-10 and CPT coding.
• Confers with third-party payers to resolve billing issues and changes in regulations.
• Respond to patient billing inquiries in a timely, courteous manner.

Connaissances

Medical billing

CPT coding

ICD-10 coding

Analytical thinking

Formation

High school diploma

Description du poste

SUMMARY:

Under general supervision of the Office Manager, the Sr Billing Specialist performs related clerical duties including review and verification of patient account information against insurance program specifications and coding review. Researches investigates high dollar claims and denials from third party payers and resolves patient/client billing inquiries. Follow up on balances due from insurance companies and analyzes surgical procedure authorizations involving ICD-10 &CPT codes. Brown University Health employees are expected to successfully role model the organization’s values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate

RESPONSIBILITIES:

Performs patient insurance billing duties such as researching claims in system, including review and verification of patient account information against insurance program specifications. Recognizes and identifies source of entry in complex multi facility organization. Follows up on payer claims denials to ensure proper re-processing of rejected claims, when appropriate. Analyzes and resolves problems with coding of surgical procedures and diagnosis using ICD-10, CPT coding. Reviews reports, records and/or bills that were prepared or assembled by others in order to ensure that information is correct. Contacts other departments or personnel as necessary to resolve errors and omissions. Obtains patient registration information. Courteously and accurately completes patient registration. Confers with representatives of third-party payers to resolve billing issues and to discuss changes in regulations/policies affecting billing system. May download bills from system to assist with disputed claims. Responds to patient billing inquiries in a timely, courteous manner. Keeps current with billing guidelines. Performs other related duties as assigned.

MINIMUM QUALIFICATIONS:

BASIC KNOWLEDGE: High school level of knowledge or equivalent. Experience with CPT4, ICD-9/10, HCPCS, coding guidelines as well as reimbursement policies and procedures. EXPERIENCE: 4+ years’ experience in a fast-paced medical office or billing service environment; familiar with aspects of third-party billing. Experience must demonstrate thorough knowledge of medical billing and claims processing, effective customer service experience, medical and procedure coding, medical terminology, knowledge of personal computers and critical thinking. Experience should represent familiarity with coding principles of CPT, ICD-10 coding and related terminology for hospital billing. Analytical ability to research and resolve billing problems and to analyze billing activity. WORK ENVIRONMENT ANDPHYSICAL REQUIREMENTS: Work is performed in a physician office practice billing environment. INDEPENDENT ACTION: Incumbent follows general office procedures and policies. Complexities are referred to Patient Financial Services. SUPERVISORY RESPONSIBILITY: None.

Pay Range:

$22.04-$36.37

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

Brown Health Medical Group - 167 Point Street Providence, Rhode Island 02903

Work Type:

M-F 8:00am-5:00pm

Work Shift:

Day

Daily Hours:

** **

8 hours

Driving Required:

No