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Company: Barton Health
Location: Zephyr Cove-Round Hill Village, NV
Career Level: Associate
Industries: Healthcare, Pharmaceutical, Biotech

Description


Summary of Position:

A Physician Billing Specialist is responsible for the accurate and timely submission and follow up of insurance claims for our Barton owned physician practices.

 

Qualifications

Education:

  • High School Diploma or GED preferred

 

Experience:

  • 2-3 years Physician Billing experience or equivalent Medical Office experience preferred.

 

Knowledge/Skills/Abilities:

  • Typing and computer literacy
  • Reading and writing skills
  • Professional phone etiquette
  • CPT/ ICD-10 knowledge preferred
  • Sufficient computer skills as are required to complete an online application and the pre-employment/annual Net Learning requirements
  • In compliance with patient safety standards, must be able to effectively communicate in English.

 

Certifications/Licensure:

  • N/A

 

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • While performing the duties of this job, the employee is frequently required to walk, stand, sit, and talk or hear.
  • The employee is occasionally required to use hands to finger, handle, feel or operate objects, tools, or controls; and reach with hands and arms.
  • The employee is occasionally required to climb or balance; stoop, kneel, crouch, or crawl.
  • Specific vision abilities required by this job include close vision, color vision, and the ability to adjust focus.
  • The employee must occasionally lift and/or move up to 25 pounds.

 

Working Conditions

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • Normal office environment. The noise level in the work environment is usually quiet to moderate while in the office.
  • Occasional travel to various health system locations.

 

Essential Functions

  1. Provides consistently exceptional care at all times.
  2. Reviews charges daily to ensure accuracy.
  3. May enter charges.
  4. Scrubs claims in billing software to ensure accurate submission of all claims on CMS- 1500 and UB-04 claim types.
  5. Works with physician office staff and coding department to have charge and code corrections approved.
  6. Follows up on assigned workload to include: Charge review WQ's, claim edit WQ's, No response Wq's, Denial Wq's, Credit WQ's. 
  7. Ensure claims are paid accurately according to payor contracts.
  8. Appeals denials.
  9. Responds to the needs of the department by performing other duties, as necessary.

 


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