Insurance Billing Specialist - VanderHouwen & Associates, Inc. - Portland, OR

Insurance Billing Specialist - VanderHouwen & Associates, Inc. - Portland, OR -

The aim of the Insurance Billing Specialist place is to make sure correct, compliant, and well timed billing and applicable reimbursement for all inpatient, outpatient and professional medical and dental service from all payers for service rendered by our shopper. This will embrace correct and well timed identification and completion of registration, billing, cost posting, contractual write-offs, changes, comply with-up, and assortment of unpaid accounts, per state and federal insurance laws for members and non-members receiving providers.

Obligations of the Insurance Billing Specialist:
Evaluation and proper all billable claims (main, secondary, tertiary) in applicable billing software program packages in accordance with particular payer tips and necessities.
Work to resolve questions associated to the ICD-9 (10), CPT/HCPCS, Income Codes, Modifiers, cost entry errors and different questionable declare parts.
Assessment line gadgets within the on-line system to make sure an accurate affected person stability.
Comply with-up with all payers on accounts receivable to make sure immediate and correct reimbursement, per insurance tips.
Validate remedy plans, ABN’s, authorizations, and submit the knowledge appropriately on the right payer type/system.
Confirm affected person demographics and insurance protection by means of on-line verification methods.
Evaluate reimbursement towards the funds acquired from co-funds, authorities payers and different payer sources.
Submit requests for changes, ABN’s, appeals, credit score balances, and refunds.
Reconcile accounts by figuring out the right insurance and affected person duty by way of interpretations of cost and denial codes on the reason of advantages despatched by payer.
Make changes in legacy pc system.
Doc in account notes causes for billing delays and actions taken.
Evaluation and proper account discrepancies.
Work all assigned work queues to determine well timed billing.
Assessment and reply to mail, correspondence, and studies each day.
Course of requests for co-pay summaries and/or itemized payments.
Evaluate declare studies, resolve points and resubmit claims.
Evaluation and resolve non-coated costs in accordance with procedures, and assessment and write-off fees that aren’t applicable.
Carry out different duties as requested, according to job description.

Qualifications of the Insurance Billing Specialist:
One yr of expertise in medical billing and/or affected person accounting, claims adjusting on a posh on-line system required.
Expertise utilizing Epic required.
In depth pc and phone expertise.
Highschool diploma or GED equal (required at time of rent).
Sort/keyboard 20 wpm.
Show 10-key calculator capability.
Primary information of all features of UB-04 and/or CMS 1500 fields and necessities.
Working information of Excel and different enterprise software program.
Working information and software of medical terminology, normal billing codes.
Information of state and federal insurance laws.
Working information of insurance laws, as they pertain to assortment points.
Primary information of accounting rules.
Accuracy with numbers.
Information of phone assortment methods.
Wonderful verbal and written communication expertise.
Drawback fixing, listening and battle decision expertise.
Capability to speak and negotiate successfully with clients and third social gathering payers.
Wonderful group expertise.
Element oriented with organizational expertise which contain the power to prioritize and handle workflow, to supply top quality work, to work independently with minimal supervision and the power to make use of logic.

Most popular Qualifications
One yr of expertise with medical terminology and coding tips most popular.
Two years of basic workplace expertise working with complicated on-line system most popular.
Two years of upper schooling in associated research, or three years of expertise in medical billing area or associated place most popular.
Capacity to shortly analyze and develop options to complicated points most popular.
Information of billing necessities, protection and advantages of personal well being insurers, federal and state businesses most popular.
Means to concurrently reply telephones, each inbound and outbound, and document written info on-line most popular.
To have the ability to carry out complicated detailed, confidential work in a extremely distracting surroundings most popular.

Advantages
Advantages can be found to eligible VanderHouwen contractors and embrace protection for medical, dental, imaginative and prescient, life insurance, brief and long run incapacity, and matching 401okay.

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