Billing Specialist

Posted 6 days ago
  • The Billing Specialist is responsible for the intake and processing of all provider claims adhering to established standards and practices. Identify Provider documents and claim demographics to prepare a complete and accurate record for review. Receive phone & email inquiries from providers and/or clients with questions regarding claims. Have an outstanding attention to detail, question things that do not appear correct, and possess a desire to succeed and progress quickly.
Essential Functions
  • Reasonable accommodations may be made to enable individuals with disabilities to perform the essential job functions.
  • Read, interpret & enter client claim information into the Encompass system to properly complete core functions.
  • Prepare and analyze Billing for various visit types/procedures using appropriate CPT/HCPCS coding and achieving daily and monthly metrics
  • Review and comprehend the fee schedule calculations & savings output to clients with the ability to identify inconsistencies.
  • Identify any inconsistencies in documentation to ensure proper claim processing to our clients and providers.
  • Understand the Appeal/Reconsideration process.
  • Document/update information in cases with high degree of accuracy.
  • Provide phone support, email & mail communications with both clients & providers. Represents Encompass in a professional manner. Treats all customers, internal and external, in a courteous and cooperative manner.
  • Work closely with interdepartmental operations staff to effectively manage referrals.
  • Understand & comply with all HIPAA & SOC2 requirements necessary in working with designated PHI.
  • Perform additional support functions as needed.
  • Data entry by touch
  • Exemplary Customer Service Skills
  • Proven ability to perform with a high degree of accuracy under tight deadlines.
  • Attention to detail, Highly Organized
  • Excellent analytical skills, communication skills and the ability to work independently as well as being a team player.
  • Ability to multi-task
  • Proficient in all MS Office and computer application systems
  • Excellent verbal and written communication skills
Supervisory Responsibility
  • This position has no supervisory responsibilities.
Work Environment
  • This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.
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.
  • While performing the duties of this job, the employee is regularly required to talk and hear. The employee is frequently required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms. The employee must be able to lift a minimum of 10lbs.
Position Type and Expected Hours of Work
  • This is a full-time position. Days and hours of wo rk vary based on the needs of the business. Evening and weekend work may be required as job duties demand.
  • No travel is expected for this position.
Required Education and Experience
  • Associate’s degree or equivalent number of years’ experience.
  • Customer service (with call center & healthcare experience a plus)
  • Minimum typing speed of 45 WPM.
Preferred Education and Experience
  •  Experience in healthcare (provider network service a plus)
Other Duties
  • Please note this job description is not designed to cover or contain a comprehensive listing of activities,duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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