Financial Specialist (Collections) - Institutional Review Board

The Financial Specialist is responsible for billing and collection activities, which may include verification of insurance, pre-certifications, deposits and reconciliation of co-pays and self-pays, updating financial information in appropriate software applications and providing information on billing matters.

• Ensures claim edits and accounts receivables are resolved in an efficient and timely manner.
• Monitors collections for Institutional Review Board.
• Resubmits claims for payment with appropriate updates and documentation as needed.
• Responds to patient and third party inquiries; researches and resolves problems; corrects errors and refers most complex issues to supervisor.
• Reviews correspondence and rejection data from insurance carriers; posts rejections and balances in appropriate financial classification.
• Transfers secondary balances to appropriate financial class and provides documentation for processing the claims.
• Reviews Credit Letter Sent (CLS) and transfers balance to appropriate financial class and dunning level.
• Prepares and submits referring physician updates and other major dictionary or master file request to supervisor for approval.
• Assists Billing Manager with the training of new hires.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Performs other related duties

• High School graduate or equivalent. Advanced medical billing and computerized billing system training.
• 3 years healthcare billing experience working with CPT and ICD (coding and CCI edits.
• Electronic claims processing preferred.