Job Details

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Summary

Under the supervision of the Billing Supervisor in a large multi-specialty physician group, the Billing Specialist is responsible for submitting accurate claims to payers and resolving errors from claim scrubbing in the practice management system, clearinghouse, and payer.

Responsibilities

1. Review federal and state documentation for billing regulation updates.
2. Research payer policies and billing guidelines for professional billing.
3. Stay current with billing rules and regulations.
4. Resolve billing issues identified during claim scrubbing, such as patient demographics, insurance details, or provider type.
5. Submit paper claims with attachments as needed.
6. Identify trends and collaborate with IS staff to prevent issues, recommending billing edits for the practice management system.
7. Perform claims testing when new departments are built or existing ones are changed.
8. Communicate with practices to resolve multiple claim issues and prevent errors during electronic billing.
9. Work with the clearinghouse to resolve issues.
10. Collaborate with Claims follow-up and Hospital Billing teams to ensure workflow efficiency.
11. Report issues that could impact revenue or prevent clean claims to the supervisor.
12. Maintain productivity and accuracy standards.
13. Participate in educational programs and training sessions.
14. Assist in training new employees.
15. Maintain quality assurance, safety, environmental, and infection control standards.
16. Perform other related duties as required.

Minimum Requirements

• High School diploma with proficiency in MS Office, especially Excel and Word.
• One to two years of medical billing experience preferred.

Additional Information

Work is performed in an office setting, requiring extended sitting periods. Brown University Health is an Equal Opportunity employer and a VEVRAA Federal Contractor.

Job Details

• Location: Providence, RI
• Type: Full-Time
• Shift: Shift 1
• Union: Non-Union

Additional Info

• Seniority Level: Entry Level
• Job Function: Accounting, Auditing, and Finance
• Industries: Hospitals, Healthcare, Medical Practices, Mental Health Care