About this role
The Ancillary Billing Specialist is responsible for monitoring denial trends, producing revenue and claims reports, and working claims that have been denied by insurance carriers. This includes processing appeals and providing any additional information necessary to obtain reimbursement. This position provides guidance and information to the ancillary operations team to manage current billing and claim issues and set future strategy. The Ancillary Billing Specialist focuses their work solely on ancillary service lines including imaging/radiology, physical therapy, cardiac testing, and infusion services.
- Full Time/Benefits Eligible
- Monday-Friday - 8:00am-5:00pm
- Westerville, OH
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Work listing of aged accounts and respond to incoming correspondence from insurance payers and/or sites to resolve any billing issues that delay reimbursement.
- Develop reports for billing, collections, and denials for each service line.
- Collaborate with partners and vendors to ensure correct information is shared timely.
- Analyze patient accounts, identify billing issues, and determine solutions with insurance companies. Take appropriate actions as needed such as re-filing claims, requesting adjustments, refunds, etc.
- Update patient demographic information and make any necessary system corrections to the patient account.
- Act as a liaison between patient and payer when needed to provide patient and/or payer with clear and accurate billing information or other pertinent information to expedite payment.
- Conduct research to provide clear and accurate account information.
- Report trends or specific issues to management regarding insurance claims.
- Recommend quality and/or process improvement initiatives in order to more effectively and efficiently perform the job functions of this position.
- Adhere to the HIPAA guidelines regarding confidentiality relating to the release of financial and medical information.
- Maintain the values and philosophy of the mission statement of the company.
- Attend meetings and complete training with the Revenue Cycle and Ancillary teams as needed.
- Performs all other duties as assigned by management.
QUALIFICATIONS:
A. Experience, Education, Licensures & Certifications
- Preferred: High School diploma or GED
- Required: 1+ year experience in healthcare revenue cycle
- Required: Experience working with Epic EHR
- Preferred: Experience developing financial reports and trends
B. Knowledge, Skills & Abilities
- Understanding of medical insurance (Commercial, Medicaid and Medicare) and the claims process
- Ability to demonstrate a high level of confidentiality
- Working knowledge of Office 365 (Teams, Word, Excel and Outlook) and EHR systems (Epic)
- Adaptability to learn new software systems
- Self-motivated with ability to work independently or as a team member
- Capable of performing multiple tasks and while using time management skills
- Possess strong analytical skills with the ability to identify issues, the root cause and a resolution.