About the Job
Our Billing Specialists are responsible for handling patient inquiries, reviewing unpaid or denied insurance claims, submitting insurance appeals, and managing assigned accounts receivables in accordance with clinic policies.
Work Hours: This role supports a client in Oregon and requires working from 8:00 AM to 5:00 PM PST.
Essential Duties & Responsibilities
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Assist with processing insurance claims, including worker’s compensation (if applicable), for all financial classes.
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Communicate with insurance companies to ensure timely payment of claims; identify and resolve account or insurance errors; record all actions and maintain accurate records of patient accounts.
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Manage claims appeals and reviews; track claims aging status and follow up on open claims.
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Address patient inquiries and concerns regarding their accounts; verify balances and ensure refunds are accurate.
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Stay updated on clinic and insurance industry policies, procedures, and medical terminology.
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Participate in professional development to stay current with best practices in healthcare.
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Contribute to the development of innovative data and analytics solutions for modern orthopedic business offices.
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Perform other duties as assigned.
Required Skills
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High school diploma or equivalent; college courses or certification preferred.
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Strong communication skills, particularly over the phone, to build and maintain positive relationships with patients, physicians, and colleagues.
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Ability to gather, organize, and understand insurance information, including contracted fee schedules.
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Proficiency in computer systems, with a preference for 50 WPM typing speed.
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Knowledge of, or ability to learn, insurance industry practices and medical terminology in a clinical setting.
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Strong analytical abilities with a passion for contributing to innovative solutions.
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Quick learner with a desire to enhance team processes and solutions.
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Alignment with core values: resilience, altruism, communication, achievement, and determination.
Preferred Skills
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At least two years of billing experience in a hospital or surgical setting.