Billing Specialist

Description

Georgia Spine & Orthopaedics is a Comprehensive Spine and Orthopedics Care provider in GA. Our locations include Atlanta, Columbus, Gwinnett, Marietta, Tucker, Stockbridge, Roswell, and the Surgery Center of Roswell. We specialize in offering cutting-edge treatment with a conservative approach.

We are a team of friendly, ambitious professionals coming to work to provide exceptional care to our patients while having a great time working together.

The role of the Billing Specialist for Workers' Compensation is designed to ensure the optimization of revenue recognition throughout the organization. Under the direction and supervision of the Billing Manager, the Billing Specialist will work with the Workers' Compensation Coordinator, Intake/Front Office, and Care Coordinators to review data required by Workers' Compensation to ensure data completeness and accuracy. The billing specialist will alert the Billing Manager to any trends with respect to claims pended or denied by Workers' Compensation, along with any other reimbursement issues. The Billing Specialist will “scrub” all data relevant to the Workers' Compensation revenue cycle to be sure that charges are billed correctly and on a timely basis. The Billing Specialist will challenge inaccurate payments or denials of payment. 

Billing Specialist-Workers Compensation Duties

• The duties and responsibilities below shall be learned and then delegated to the assistant office manager at the office manager’s discretion:
• Serve as the first line of assurance that patient and payment information is accurate, complete, and entered into our software system(s) promptly.
• Enter charge data on a daily basis.
• Notify the appropriate team of any missing or incomplete data to be corrected.
• File invoices or claims as directed by the Billing Manager. 
• Monitor invoices and claims for timely payment or notification of denial
• Enter payments. Enter write-offs according to the company’s policy per payer. 
• Challenge any payment that is not in accordance with the company’s agreement or contract.
• Serve as a point of reference for coding, billing, pricing, and payment issues. 
• Cross-train to cover all appropriate roles in the event of a staffing shortage. 
• Prepare daily, weekly, and monthly reports as requested by the leadership team. 
• Ensure coordination of the Central Business Office Team as a whole and with other areas of the company.
• Assist medical providers with any issues/projects as needed.
• Monitor/maintain a positive work environment. 
• Answer incoming office calls regarding revenue-cycle issues as required. 
• Other duties as requested. 

Requirements

Additional Requirements:

• Demonstrated understanding of healthcare billing specific to Workers' Compensation 
• Demonstrated familiarity with ICD-10 and CPT coding and Workers Compensation Fee Schedules
• Demonstrated ability to understand the specific rules, regulations, and forms required by Workers' Compensation, such as pre-certification, prior authorization, and requests to change or add a provider of care. 
• Ability to understand and review charge/demographic/financial data for completeness and accuracy. 
• Demonstrated ability to post charges, payments, and write-offs.
• Demonstrated ability to collaborate with Workers' Compensation case managers, attorneys, insurance adjusters, and employer groups to ensure optimal client satisfaction and optimization of revenue capture. 
• Ability to review and challenge payment reductions or denials. 
• Collaboration, teamwork, and problem-solving to achieve goals.
• Demonstrated skills in written and verbal communication and listening.
• Demonstrated skills in providing excellent service to customers.
• An elevated level of integrity and trustworthiness to keep information confidential.
• Develop skills and proficiency under the direction of the office manager to deliver constructive feedback to staff along with corrective action when necessary.
• Develop skills to hold staff accountable to expectations.

Billing Specialist- Workers' Compensation Benefits & Perks

• 401(K)
• Great benefits package including medical, dental, vision, and multiple add-ons available.
• Paid time off
• Paid holidays
• Multiple areas and opportunities for advancement
• Mileage reimbursement and travel stipends available