Job Description

Summary:

Under general supervision of the Billing Supervisor for a large multi-specialty physician group the Billing Specialist is responsible for submitting clean claims to the payers and resolving all errors that result from claim scrubbing in the practice management system the clearinghouse and the payer.

Responsibilities:

Review federal and state documentation for changes in billing regulations. Research payer policies and billing guidelines for professional billing. Stay abreast of all current billing rules and regulations.

Resolves billing issues identified in the claim scrubbing process. Issues could be related to patient demographics insurance place of service provider type etc.

Submits paper claims with attachments as appropriate.

Identifies trends and works with IS staff to prevent issues from occurring. Recommends billing edits that need to be built in the practice management system and periodically reviews billing edits to assure they are still needed.

Performs claims testing for IS when new departments are built or a change to an existing department occurs.

Communicates with practices when multiple claim issues occur to have issue resolved so claims will not error out during electronic billing.

Works with clearinghouse to resolve issues when needed.

Collaborates with other teams particularly the Claims follow-up team and the Hospital Billing team to assure efficient workflows across all teams.

Reports any issues that could impact our revenue stream or prevent clean claims from billing to the supervisor.

Maintain productivity measures and accuracy standards defined by department.

Participate in educational programs and in-service meetings.

May participate in training of new employees.

Maintain quality assurance safety environmental and infection control in accordance with established policies procedures and objectives.

Perform other related duties as required.

Other information:

BASIC KNOWLEDGE:

High School diploma with proficiency in use of MS Office 2000 or later particularly Excel and Word.

EXPERIENCE:

One to two years' experience in medical billing professional billing preferred.

Work is performed in a typical office setting requiring extended periods of sitting

Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race color religion sex national origin age ethnicity sexual orientation ancestry genetics gender identity or expression disability protected veteran or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Brown University Health Corporate Services USA:RI:Providence

Work Type: Full Time

Shift: Shift 1

Union: Non-Union

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Job Tags

Full time, For contractors, Shift work,

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