Billing Specialist
Charleston ENT Associates, LLC - Charleston, SC

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Duties and Responsibilities:
  • Prepares and submits physician claims to third party insurance carriers either electronically or by hard copy billing.
  • Secures needed medical documentation required or requested by third party insurances.
  • Follows-up with third party insurance carriers on unpaid claims until claims are paid or only a self pay balance remains.
  • Appeals insurance denials as appropriate.
  • Processes rejections by generating a billing statement or by correcting any billing errors and resubmitting claims to third party insurance carriers.
  • Works with physician or medical coding staff to ensure that correct diagnosis/procedure codes are reported to third party insurance carriers.
  • Assists Charleston ENT Physicians, management, and staff with questions or problems related to insurance billing and reimbursement.
  • Maintains reports for review by Physicians, Billing Manager, management, and staff. Monitors claims for missing information, authorizations, and denial notifications.
  • Receives itemized list of proper payment postings and compares total to payment method received from insurance carrier.
  • Posts third party insurance payments and denials to patient’s accounts.
  • Posts payments made by patients to include cash, checks, and credit cards.
  • Runs credit card charges.
  • Updates patient’s accounts with regards to billing status.
  • Performs charge entry for assigned offices.
  • Manages third party authorizations for procedures and products.
  • Answers customer inquiries by phone, fax, and email. Processes patient refunds.
  • Enters patient demographics.
  • Balances at the end of the day.
  • Work special reports and projects.
  • Keeps updated on all billing and benefit changes for third party insurance carriers within their area of responsibility and reports these changes to Billing Manager.
  • Maintains confidentiality of all information.
  • Completes work within authorized time to assure compliance with departmental standards.
  • Demonstrates knowledge of, and supports, practice mission, vision, value statements, standards, policies, and procedures, operating instructions, confidentiality standards, and the code of ethical behavior.
  • Performs others duties as required.