The Lead Billing Specialist (Biller) is responsible for the performance of a broad range of billing activities related to processing of claims for physician and practice-related ancillary services. The Lead Billing Specialist will maintain expertise in claims submission, accounts receivable management, interpretation of related practice documentation, and other relevant tasks in order to support a best-in-class patient care platform. The Billing Specialist will also demonstrate proficiency in multiple applicable software systems in addition to growth in areas supporting physician services including physician-administered drugs, imaging, and other ancillaries.
Responsible To:
Director, Revenue Cycle Management
Education/Experience:
High School Diploma or equivalent (GED) required
Prior physician office and infusion drug experience highly preferred
Excellent interpersonal, communication and organizational skills required
Ability to prioritize, problem solve, and multitask is required
MAJOR RESPONSIBILITIES
Proactively submits and processes assigned third party payor billings (primary, secondary claims) to maximize accurate and timely billing
Achieves daily accomplishments that produce progress towards monthly, quarterly and annual cash collection and accounts receivable goals
Actively engages in assigned quality assurance tasks to safeguard accurate and timely claims creation including compliance with organizational policies and payor guidelines
Identifies unresolved or incomplete work product within assigned scope of responsibilities for follow up and escalation in a timely fashion
Identifies areas of opportunity or potential patterns of noncompliance during normal course of responsibilities and escalates appropriately for review
Anticipates most efficient resources and activities needed to secure payment of open claims and invoices including use of online payor policy research, electronic submission tools, or appropriate escalation or triage
Performs other duties as required.