Insurance Billing Specialist
Job Title: Insurance Billing Specialist
Reports To: CIO / Business Operations
Status: Non-Exempt; Part-Time (24hrs/week)
The Insurance Billing Specialist is responsible for the day-to-day task of the medical billing cycle, including charge reconciliation and posting, accounting system entries, payment tracking, denial management, and accounts receivable follow-ups.
This position is responsible for maintaining an up-to-date knowledge of changes in the insurance market, private and government, and ensuring that ZRT Laboratory maintains full compliance.
Additionally, the Insurance Billing Specialist will participate in various strategic projects to ensure that Insurance Billing requirements are fully considered as part of any new project or process change.
This position will partner with internal employees to help educate on insurance billing processes and requirement and will communicate with Payers and ZRT’s customers (Providers) to help resolve any insurance billing issues.
- Responsible for the timely submission of medical claims to various insurance companies electronically or by paper.
- Submit insurance claims through electronic medical record systems and manually, depending on the requirements of various private and government payers.
- Communicates effectively with coworkers, patients, providers, and insurance companies pertaining to insurance billing processes, as necessary.
- Works resolution issues to ensure ZRT policies and procedures are being followed.
- Performs various follow-up actions on claim denials including contacting patients or insurance companies by phone or correcting and resubmitting claims as deemed necessary.
- Review of underpayment and denials, research, and correct errors to maximize reimbursement.
- Reviews monthly aging reports and prepares patient collection letters in compliance with internal collection procedures.
- Prepare regular insurance tracking, reconciliation, and reporting.
- Posts and notes patient and insurance Accounts Receivable, balancing, and year-end reporting.
- Assigns proper CPT code to new testing and verifies proper CPT codes are being used to reflect correct billing practices.
- Add ICD-10 codes to internal LIMS (laboratory information management system) when appropriate.
- Prepares refund requests and relevant letters relating to insurance and patient accounts.
- Maintains up-to-date knowledge of current ICD-10 and CPT coding practices.
- Works directly with the Senior Accountant to develop processes and procedures to optimize work performance and ensure compliance with third party and governmental regulations.
Experience or background required:
- Associates degree from an accredited 2-year institution and/or minimum 5 years of medical billing experience
- Professional Billing certificate or 2 years recent medical billing experience preferred
- Current ICD-10, CPT coding, and medical terminology knowledge
- Knowledge of Medicare policies and procedures
- Must be comfortable navigating multiple computer applications, various online insurance company portals, and clearinghouse websites
- Full cycle billing experience
- Excellent customer service skills
- Ability to operate a computer and basic office equipment.
- Strong data entry skills
- Ability to read, understand and follow both oral and written instructions
- Ability to work independently and as a team
- Microsoft Office
- Proprietary software
- Must be able to sit for long periods of time to perform this work.
- Must be able to use a telephone for long periods of time.
- Must be able to use hands to perform a variety of repetitive tasks.
- May require some bending and/or lifting.
This description is intended to provide only basic guidelines for job requirements. Responsibilities, skills and working conditions may change as needs evolve.
Contact Human Resources to apply at email@example.com.