Insurance Billing Specialist

Description:

Summary:

A Billing Specialist maintains current understanding of billing and coding guidelines that affects the organization practices to ensure claims are consistently billed properly. Responsible for reviewing and resolving claim edits in the billing scrubber for all government and non-government payers; submits claims withing 48 – 72 hrs of creation date; responsible for coordinating rebill requests from internal Compliance department, collections team, audit team, customer service, HIM, and vendors among other areas. May serve as liaison between Revenue Cycle areas and the billing agency to resolve problematic claim edits. Conducts all duties in a professional and timely manner.

Minimum Education/Experience:

Minimum two (2) years’ experience in medical insurance billing required (preferably in facility billing)

Soarian Financials experience required

Primary Accountabilities:

Support Soarian Financials Billing Edits and Billing Processes

Medical Enterprise - Non-Clinical Onboarding - Must complete all onboarding requirements prior to the start date, with no exceptions.

Minimum of two (2) years of experience in medical insurance billing: Experience should ideally be in facility billing to ensure familiarity with the relevant processes.

Experience with Soarian Financials: Proficiency in supporting billing edits and processes within Soarian Financials is essential for this role.

Strong understanding of billing and coding guidelines: The candidate must have a solid grasp of billing and coding regulations for government and non-government payers to ensure claims are properly billed.

Coordination and communication skills: The ability to work with multiple internal departments (Compliance, Collections, Audit, Customer Service, HIM, etc.) and act as a liaison between the Revenue Cycle areas and the billing agency to resolve claim issues.

Attention to detail and timeliness: Must demonstrate professionalism and efficiency in all aspects of claim submission, rebilling, and resolution processes.