Description
Patient Financial Services Itemized Billing Specialist
Duration: 12 months assignment (W2)
Location: Rockville, MD 20852
Job Number: 75623
Compensation: $20/hr
Standard Work Hours:
- Flexible -normal business hours are M-F 8:30 AM to 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, attorneys, 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
- Advises management of pending changes
- Performs other duties as directed.
Required Qualifications:
- High School Diploma or equivalent
- Minimum 4 years' billing/coding experience to include knowledge of knowledge of CPT, ICD-9, HCPCS codes
- Experience with/knowledge of Worker's Compensation and Third-Party Liability
- Experience with/knowledge of commercial and Medicare billing procedures and regulations
- Knowledge of compliance medical and insurance terminology
- Familiarity with CMS 1500 and UB 92
- Knowledge of Microsoft Word, Excel, and Access
Preferred Qualifications:
- Bachelor's Degree
- Billing and/or Coding certification
- Experience with/knowledge of HealthConnect, Lotus Notes, and Diamond
Interview Steps and Information:
- Face-to-face only, both with Manager and 1 to 2 team members
- We will go over the candidates' background and cover their experience in the Healthcare Industry as it relates to their daily tasks