Sr Billing Specialist WMCG

Wellstar Health Systems; Augusta (GA); On-site; USD 40,000 - 70,000; Full time

Job summary

Wellstar Health System is seeking a billing specialist to manage first-time submission of government and non-government claims to payors. The role involves reviewing claims in EPIC, fixing errors, and ensuring clean submissions.

The ideal candidate has at least 2 years of hospital insurance billing experience, with strong Excel/Word skills and knowledge of ICD9/10-CM and CPT codes. Training others and effective cross-department communication are important.

Qualifications

• High School Diploma or GED required.
• Minimum 2 years of insurance billing experience in a hospital setting.
• Experience with Excel and Word required.
• Knowledge of ICD9-CM, ICD10-CM, CPT codes relevant to hospital billing.
• Ability to train other billing staff on edits and denials.
• Strong written and verbal communication and time management skills.
• Attention to detail with analytical and problem solving abilities.

Responsibilities

• Process first-time billing for governmental or non-governmental claims to third-party payors.
• Review and troubleshoot claims within the billing system to correct errors and edits.
• Maintain billing workqueues and generate clean claims.
• Correct payor rejections and denials in EPIC to expedite payments.
• Train billing specialists on billing edits, claim errors, and denials.
• Communicate with ancillary departments to resolve claim issues and expedite bills.

Skills

Excel

Word

Medical terminology

ICD9-CM/ICD10-CM codes

CPT codes

Analytical thinking

Problem solving

Training others

Written and verbal communication

Time management

Education

High School Diploma General or GED

Tools

EPIC Workqueues

Job description

How would you like to work in a place where your contributions and ideas are valued? A place where you can serve with compassion, pursue excellence and honor every voice? At Wellstar, our mission is simple, yet powerful: to enhance the health and well-being of every person we serve. We are proud to have become a shining example of what's possible when the brightest professionals dedicate themselves to making a difference in the healthcare industry, and in people's lives.

Work ShiftJob Summary: Responsible for first time billing of either governmental or non-governmental claims to third party payors. Capable of reviewing and troubleshooting claims within the billing system to correct errors, edits, or nuances preventing a bill from going to the payer.

Core Responsibilities and Essential Functions:

• EPIC Workqueues-Maintains billing workqueues assigned by alpha or groupings which generates claim edits requiring billing intervention to create clean claims.
• Payor Rejections-Maintains and corrects claims returned to the biller workqueue in EPIC that have been rejected by the payor.
• Denials-Maintains and corrects claims returned to the biller workqueue in EPIC that have been denied by the payor.
• Training-Able to train billing specialist to work billing edits, claim errors, and denials within the billing system
• Communication-Able to effectively communicate with ancillary departments to resolve claim issues to expedite bills to payers.
• Performs other duties as assigned
• Complies with all Wellstar Health System policies, standards of work, and code of conduct.

Required Minimum Education:

• High School Diploma General or GED General

Required Minimum License(s) and Certification(s):

• All certifications are required upon hire unless otherwise stated.

Required Minimum Experience:

• Minimum 2 years experience in insurance billing in hospital environment; Microsoft Word and Excel expereince Required

Required Minimum Skills:

• Experience in Excel and Word.
• Demonstrates a general knowledge of medical terminology, ICD9-CM, ICD10-CM, and CPT procedure codes relative to hospital practices.
• Competent written and oral communication skills, time management organization, and an attention to detail.
• Displays strong knowledge of analytical and problem solving skills.
• Is able to train Billers on billing edits, claim errors and denials.

Join us and discover the support to do more meaningful work-and enjoy a more rewarding life. Connect with the most integrated health system in Georgia, and start a future that gives you more.