Physician Practice Billing Specialist

Under supervision and through the use of the Physician Billing’s medical claim billing software, Epic, the Physician Practice Billing Specialist is primarily responsible for communicating with all insurance carriers.  This position is also responsible for researching insurance company issues, such as network problems, workers compensation claims, and a variety of special projects.  This position requires a comprehensive understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payers.  Proactively contact carriers regarding reduced or denied reimbursement; ensure patient insurance information is accurate.  Retrieve various types of medical documentation.  Develop, submit, and track appeals to carriers, per department procedure.  Review and analyze explanation of benefits, and adjust patients’ accounts to reflect the carrier’s decisions on the patient’s statement.  As a Payment Posting Specialist receives and accurately records all SBO patient pays and third-party mail payments for services rendered using the Physician Billing’s medical claim billing software, Epic.  Ensures data input has been recorded properly and timely by reconciling to daily reports.  Must be able to balance bank deposits.

At Garnet Health, we are committed to supporting your career growth and professional potential. We are responsive, attentive and dedicated to the success and satisfaction of our team members. Here, you’ll find resources that will help you excel in your career, tuition reimbursement programs for your continued education, and comprehensive health, dental and retirement benefits designed to fit your individual and family needs. Our inclusive and diverse team culture encourages you to contribute your exceptional talents, skills and perspectives to the success of our system, one another, our communities and our patients. Join the Garnet Health team and let your excellence shine.

Minimum Education: • High School diploma or High School Equivalent or Associate Degree (preferred).

Minimum Experience: • Three years of billing experience needed• Multi-specialty practices/facilities experience preferred. • Should understand third-party healthcare reimbursement regulations. • Basic knowledge of Medical Terminology, ICD-10, and CPT coding. • Excellent communication, interpersonal, analytic, organizational, and problem-solving skills. • Must be PC and Microsoft Office proficient and must be able to access specialized healthcare websites via the World Wide Web.

Required Certification/Registration: • N/A

Physical Requirements: • Work is sedentary with intermittent walking and standing, visual acuity and ability to communicate with others.Working Conditions:• Environmental Demands and Exposure to Hazards: Works in a clean, well-lighted, heated or ventilated facility. No routine exposure to hazards.• Physical Demands: Demonstrates physical and functional ability to perform full anatomical range of motion to accomplish tasks. Evidence of visual and aural acuity and finger and hand dexterity to operate computer and office equipment. Can withstand long periods of sitting, standing and/or constant walking. Ability to lift 10 lbs.• Mental Demands: Ability to foster collaborative relationships, to work well under pressure, to organize and synthesize new information, and prioritize tasks. Possesses critical thinking, analytical skills and flexibility. Ability to multi-task. Required detailed attention to work in an environment where interruptions cannot be controlled. Demonstrates sensitivity to customer needs and expectations. May be subject to irregular hours including evenings or potentially weekends to participate in operational and community events as necessary.