Description

Description The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures, including Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. S/he coordinates activities related to data entry of billing, and demonstrates proficiency in analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager/Revenue Cycle Manager. Responsibilities Performs specialized coding services for inpatient and outpatient medical office visits. Reviews physician coding and provides updates. Provides comprehensive financial counseling to patients. Responsible for setting patient expectations, discussion of financial options, payment plans, one-time settlements and resolution of unpaid balances. Discusses with patients the details concerning their insurance coverage and financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or ...