Job Details

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

Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another. In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include: Instill Trust and Value Differences Patient and Community Focus and Collaborate

RESPONSIBILITIES:

• Review federal and state documentation for changes in billing regulations.
• Research payer policies and billing guidelines for professional billing.
• Stay abreast of all current billing rules and regulations.
• Resolves billing issues identified in the claim scrubbing process.
• Issues could be related to patient demographics, insurance, place of service, provider type, etc.
• Submits paper claims with attachments as appropriate.
• Identifies trends and works with IS staff to prevent issues from occurring.
• Recommends billing edits that need to be built in the practice management system and periodically reviews billing edits to assure they are still needed.
• Performs claims testing for IS when new departments are built or a change to an existing department occurs.
• Communicates with practices when multiple claim issues occur to have issue resolved so claims will not error out during electronic billing.
• Works with clearinghouse to resolve issues when needed.
• Collaborates with other teams, particularly the Claims follow-up team and the Hospital Billing team to assure efficient workflows across all teams.
• Reports any issues that could impact our revenue stream or prevent clean claims from billing to the supervisor.
• Maintain productivity measures and accuracy standards defined by department.
• Participate in educational programs and in-service meetings.
• May participate in training of new employees.
• Maintain quality assurance, safety, environmental and infection control in accordance with established policies, procedures and objectives.
• Perform other related duties as required.

MINIMUM QUALIFICATIONS:

BASIC KNOWLEDGE: High School diploma with proficiency in use of MS Office 2000 or later, particularly Excel and Word.

EXPERIENCE: One to two years' experience in medical billing, professional billing preferred.

Work is performed in a typical office setting requiring extended periods of sitting

Pay Range: $19.58-$32.31

EEO Statement: Brown University Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, age, ethnicity, sexual orientation, ancestry, genetics, gender identity or expression, disability, protected veteran, or marital status. Brown University Health is a VEVRAA Federal Contractor.

Location: Corporate Headquarters - 167 Point Street Providence, Rhode Island 02903

Work Type: Monday - Friday 7:30-4

Work Shift: Day

Daily Hours: 8 hours

Driving Required: No