PATIENT FINANCIAL SERVICES ITEMIZED BILLING SPECIALIST - 12 months (71

Maryland  ‐ Onsite
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Description

PATIENT FINANCIAL SERVICES (PFS) ITEMIZED BILLING SPECIALIST

Contract: 12 months (W2)

Location: Rockville, MD 20852

Job Number: 71694

Client: One of the country's largest health care and health plan providers

Department: Patient Accounting

Standard Work Hours: M-F 8:30 AM-5:00 PM; some adjustment may be needed as scheduling conflicts arise

Essential Functions:

  • Generates and analyzes applicable departmental itemized billing reports requested by members, attorneys and third party insurance adjusters according to departmental policy
  • Investigates and resolves situations which require research or adaptation of responses and document action taken to resolve billing discrepancies and unusual charges and credits
  • Process incoming correspondence and makes the determination of related billable and non-billable third party encounters for subrogation cases
  • Acts as a liaison to the Billing, Coding and Collection Units; provides assistance to other units with regard to itemized billing requests
  • Responds to the billing inquiries from members, attorney's, carriers, other units within PFS, as well as Membership Services and Patient Accounting, when applicable
  • Resolves account issues including resubmitting claim if not on file, verify/confirm patient information for reprocessing, identify information needed to correctly process encounter and generally work through issues in order to process requests quickly
  • Escalate problematic accounts to the attention of the Billing Coordinator in order to resolve issues quickly and efficiently
  • Provides feedback to Financial Coders regarding coding and billing edits
  • Receives and responds to incoming customer calls pertaining to the itemized statements
  • Interprets federal and state laws and regulations in all operating jurisdictions for TPL, WC CMS, NAIC
  • Communicates changes in regulations appropriately to all interested parties. Advise management of pending changes
  • Performs other duties as directed

Required Education, Experience, and Skills:

  • High School diploma or equivalent
  • Minimum 4 years' billing/coding experience to include knowledge of CPT, ICD-10, HCPCS codes
  • Experience with/knowledge of commercial and Medicare billing procedures and regulations
  • Experience with/knowledge of Worker's Compensation and Third-Party Liability
  • Knowledge of compliance medical and insurance terminology
  • Familiarity with CMS 1500 and UB 92
  • Knowledge of Microsoft Word, Excel, and Access

Preferred Education, Experience, and Skills:

  • Bachelor's degree
  • Experience with/knowledge of HealthConnect, Lotus Notes, and Diamond
  • Billing and/or Coding certification

Interview:

  • Face-to-face only, with Manager and 1-2 team members
  • Go over candidate's background, covering their experience in Healthcare industry as it relates to daily tasks
Start date
early January
Duration
12 months
From
Enclipse Corp.
Published at
11.12.2015
Project ID:
1036175
Contract type
Freelance
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