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Role Description

Reporting to the Billing Manager, Billing Specialists are responsible for the daily entry of charges for their assigned surgical centers. This will include but is not limited to the following:

• Perform complete chart reviews.
• Verify patient demographics.
• Assign modifiers, diagnosis codes, and revenue codes in accordance with coding and reimbursement guidelines resulting in claim reimbursement.

Responsibilities include:

• Pull any preoperative notes from the designated transcription company.
• Extract information from medical records, operative notes, invoices, progress notes, and discharge paperwork to ensure completeness and accuracy of charge entry.
• Capture implants, high-cost supplies, high-cost drugs, post op pain blocks, and observations times prior to charge submission.
• Review accuracy of invoice details, including customer billing instructions, pricing, discounts, state sales tax, etc.
• Execute the recurring billing workflow and generate and transmit claims daily.
• Ensure timely follow-up and resolution of internal and external inquiries of billing issues (i.e., operative notes, POPM form, invoices, or implant pricing etc).
• Reconcile revenue and billing during the period-end close process.
• Complete accurate charge entry for all assigned cases and upload to designated electronic claims clearinghouse daily.
• Resolve claim rejections daily to ensure clean claims are transmitted and received by the appropriate payer.
• Maintain current knowledge of health care billing laws, rules and regulations and developments.

Company Description