UMH Sparrow Health System - BILLING SPECIALIST

General Purpose of Job:

The Hospital Billing Specialist is responsible for the accurate and timely billing, for assigned healthcare claims. This role focuses on identifying and resolving billing errors, verifying claim accuracy, and submitting clean claims to payers to support efficient revenue collection.

Essential Duties:

This job description is intended to cover the minimum essential duties assigned on a regular basis. Team members may be asked to perform additional duties as assigned by their leader. Leadership has the right to alter or modify the duties of the position.

• Review and resolve billing claim edits and errors daily, prior to submission to payers, for accuracy utilizing electronic billing software.
• Collaborates with coding, registration, and other revenue cycle and clinical departments to resolve issues impacting claim quality.
• Maintains daily work queues according to payer requirements, including late charges/credits, multiple visits in one day, 3-day rule, changes in insurance coverage, and claim errors.
• Files claims to payers in a timely manner to assure prompt reimbursement.
• Documents actions taken in the billing system according to department standards.
• Maintain quality and productivity standards and participate in meetings to discuss recurring issues.
• Knowledge of payer guidelines, including utilization of payer websites and other tools.
• Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning, and continuing education opportunities, and participating in committees, task forces, and work groups as determined by management.