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GBMC HealthCare · 1 day ago

Billing Specialist I

Baltimore, MD

Full-time

Onsite

Entry Level

$19.34/hr - $29/hr

2+ years exp

GBMC HealthCare is seeking a Billing Specialist I to perform billing and collection functions on account balances within assigned financial classes. The role involves ensuring timely submission of claims, posting payments, and handling eligibility verification and authorization requests as needed.

Health Care

Responsibilities

Manages assigned Epic work queues daily to ensure accurate billing and expedient claims follow-up

Ensures timely submission of all claims within assigned financial classes

Ensures timely follow up of all claims within assigned financial classes

Investigates claim denials or rejections

Completes functions in order to resolve claims

Uses all available tools such as but not limited to: Online access, calling the insurance companies; working with provider representatives

Identifies appeals

Identifies secondary billing for accounts with secondary liability; follows-up on any unpaid balances. Brings these claims to resolution

Identifies patient self-pay balances and bills timely to patient/family. Follow-ups as necessary including calling for follow up

Process any late charge claims, claims resubmission and/or claims corrections to payors

Enters and posts payment to patient accounts based on remittance advice review

Reconcile accounts and ensure any underpayments or overpayments are corrected

Responds to patient and third-party payor inquiries regarding patient accounts via e-mail, telephone, mail, and in person

Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission

Maintain detailed and accurate billing records for auditing purposes and compliance with industry regulations

Maintain thorough records of all communication with insurance providers and patients regarding claims

Participate in meetings with Provider Reps to resolve denial discrepancies

Prepare and submit appeals for denied claims. Understanding of additional documentation necessary to submit an appeal

Obtain an in-depth understanding of hospice billing regulations. Ensure compliance with federal, state and local billing laws, including HIPAA regulations

Prepare reports to managers recommending accounts for bad debt adjustments. Maintaining lost revenue at a level of less than 1% of net healthcare revenue

Recommends accounts for transfer to bad debt

Qualification

Medical billing experienceEpic experienceInsurance knowledgeCollection skillsEMR knowledgeComputer skillsInterpersonal skillsVerbal communicationWritten communicationProblem-solving skillsTime management