Billing Specialist

Overview

HOURY RATE (DEPENDING ON SKILLS/EXPERIENCE): $25.75 - $33.60

Part Time Position*

SCOPE: Responsible for the review and/or data entry of received charges and applying appropriate coding guidelines to insure accuracy and clean claim submission; (i.e. by assigning appropriate diagnosis codes, modifiers, splitting of claims based on DOFRs or no charging due to unbundling). Help to identify issues and report to supervisor/manager; for potential provider education, interface corrections, EPIC rules to be built or edited, etc. Ability to help/assume other assigned duties/desks as needed. Ability to troubleshoot and proactively anticipate any potential issues with charge entry/claim submission; communicating to appropriate parties, issues/resolutions. Assist other charge capture specialists with questions/clarifications and/or charge review/entering. Proficient navigation of payer websites to locate and understand guidelines, NCD/LCDs and coding tools, and how to apply the knowledge.

Responsibilities

RESPONSIBILITIES:

• Perform timely review of assigned EPIC WQs; coding and reviewing charges by site and by date of service.
• Preview charges for billing errors and apply appropriate use and knowledge of coding guideline for various specialties to insure clean claim submission.
• Enter manual charges and apply appropriate use and knowledge of coding guideline for various specialties to insure clean claim submission.
• Perform timely review of claim edit WQs to correct errors and submit clean claims.
• Approve claim run as needed.
• Audit accuracy of charges submitted greater than 95%, including complete review of pertinent data to insure clean claim submission or assistance in appeals.

Qualifications

MINIMUM QUALIFICATIONS:

• High school degree or equivalent.
• Associates degree preferred.
• Certificate Medical Billing or Insurance preferred.
• CPC preferred. 

EXPERIENCE REQUIREMENTS: 

• 3 Year Coding and posting charges in Medical Office/Hospital required.
• 2 Year EMR required. 
• 1 Year EPIC EMR preferred.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work may require sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or paper weighing up to 30 pounds. Requires manual dexterity sufficient to operate a keyboard, a calculator, telephone, copier and other such office equipment. Vision must be correctable to 20/20 and hearing must be in the normal range for telephone contacts. It is necessary to view and type on computer screens for prolonged periods of time.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Work is performed in an office environment. Involves frequent interaction with staff, patients and the public.