Billing Specialist I

We are seeking a Billing Specialist I - Remote - To provide a high level of customer service to patients, fellow employees and referral sources through performing specialized clerical and administrative technical work pertaining to the authorization and billing of clients. Typical responsibilities include, entering, reviewing and updating all billing, codes and account information, review and reconciles reports, ensure billing for all services provided is accurate, print bills to collect revenues; audit account accuracy and perform daily, weekly and month end close activities, while ensuring compliance with relevant laws, including HIPAA requirements, regulations and established Hanger policies and procedures.

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Your Impact

Depending on the operational requirements and size of the Hanger Clinic, this position may include some or all of the functions or roles listed below. 

• Obtain and maintain accurate patient, billing and insurance information, verification and pre-authorization in patient files and in the billing system, in compliance with Hanger’s Compliance Policies.
• Review charts for completed checklist or PCRE.
• Conversion of NextGen encounters after running and clearing all claim edits.
• Accurately submits paper and electronic daily.
• Acquires and maintains knowledge of manual and electronic billing systems, and specifications for contracted payers.
• Reconciles electronic billing error/submission/rejection report.
• Mails paper claims to carriers, and files resubmissions.
• Coordinates communications with payers to ensure accurate billing practices, and enhance reimbursement opportunities, in accordance with Hanger goals.
• Report timely key statistics to market and corporate management for sales, revenue, cash and patient flow.
• Perform other duties or special projects as assigned

Minimum Qualifications

Experience and Education:

• High school education or equivalent
• Minimum of one year of experience auditing or data analytics

Preferred

• Experience in a medical office
• Experience with EMR systems (NextGen and/or OnBase)
• DME/Orthotic knowledge

Additional Success Factors

• Knowlegable of professional concepts and able to properly apply company policies and procedures to resolve issues. 
• Exhibit good Interpersonal, oral (including telephone) and written communication skills, including the ability to follow written and verbal directions.
• Comfortable working in various workplace scenarios (e.g. diverse population clinicians, insurance carrier representatives, levels of management, and business representatives.)
• Knowledge of generally accepted accounting principles; applicable federal, state and local laws, statues, regulations, policies and procedures; healthcare billing principles and practices; basic mathematical principles and practices; methods and techniques receiving/accounting for payments; standard office practices and procedures; standard clerical accounting methods and practices; principles and practices of organizing and reporting data; personal computer systems and general office computer software; standard filing and record keeping systems.
• Working knowledge of ICD-9, ICD-10, HCPC/CPT and other coding.
• Ability to research, interpret and apply complex laws, regulations, policies and procedures pertaining to healthcare billing and collection activities; provide/obtain detailed information form others, even in difficult situations; gather and evaluate data; communicate effectively; maintain professional composure, even during difficult situations , both orally and in writing; establish and maintain effective working relationships with others; utilize standard office equipment, including computer hardware and software, to accomplish tasks within set deadlines; establish and maintain procedures, records and files.
• This role requires an individual of exemplary ethical standards who performs meticulous and concise work.
• Proficient computer skills, including Windows based office technologies (ex. Word, Excel, PowerPoint), computerized billing systems and report writer software. Excel or comparable spreadsheet experience required.