Billing Specialist

Billing Specialist

The Role: 

The Billing Specialist plays a vital role in our healthcare revenue cycle management company, responsible for accurately submitting insurance claims and meticulously tracking their progress through to resolution with clearing houses and payers. We seek individuals who thrive in dynamic environments, readily embracing change while maintaining a keen eye for detail and organization. The ideal candidate excels at multitasking, managing a high volume of tasks efficiently in a fast-paced setting. This role demands independent problem-solving skills and the ability to conduct thorough research to resolve billing issues effectively. Collaboration is key, so we're looking for team players with exceptional written and verbal communication skills to foster strong relationships within our organization.

Why work for Prompt RCM?

• BIG Challenges: Here at Prompt, we are solving complex and unique problems that have plagued the healthcare industry since the dawn of time.

• Talented People: Prompt didn't happen by chance, it's a team of incredibly talented and proven individuals who all made their mark before joining forces to build the greatest software on the planet for rehab therapists.

• Healthy Approach: This isn't an investment bank, we work long hours when it's needed, but at Prompt you own your workload and the entire organization takes a liking to smart work (over hard work).

• Positive Impact: Prompt helps outpatient rehab organizations treat more patients and deliver better care with less environmental waste. That means less surgery and less narcotic-based pain treatment, all while turning a paper-heavy industry digital. We aren't enthralled with patting ourselves on the back everyday, but it does feel good :)

Key Responsibilities:

• Ensure timely submission of assigned client billings to clearing houses and payers.

• Proactively manage client billings by meeting daily submission goals.

• Daily review and resolution of clearinghouse and payer rejections through the practice management system.

• Resolve root causes of Rejections via EDI Rule and PM system enhancement recommendation to continually optimize quality of outgoing claims.

• Conduct thorough research and analysis to identify and resolve client billing problems or issues, ensuring accuracy and compliance.

• Maintain open communication channels with leadership and Client Relationship Managers to verify patient demographic and insurance information and address any discrepancies.

• Collaborate with cross-functional teams to support special projects and initiatives as assigned, contributing to the continuous improvement of billing processes and systems.

Minimum Requirements:

• Knowledge of insurance billing functions

• Experience with Third Party, Governmental, HMO/PPO payers, including but not limited to Medicare, Medi-cal 

• Exceptional attention to detail and accuracy

• Displays sound judgment and reasoning abilities.

• Problem solving skills to manage a variety of concrete variables.

• Ability to interpret instructions presented in a variety of situations.

• Strong organizational skills: ability to manage multiple projects simultaneously.

• Proficient in MS Excel, Word, clearinghouses, various practice management software experience

HIPAA Requirements

All associates are required to comply with the Health Insurance Portability and Accountability Act (HIPAA) regulations regarding the protection of patient health information. This includes adherence to the organization's Notice of Privacy Practices and HIPAA Privacy Policies and Procedures.

The specific statements provided in this job description are not exhaustive and may be subject to change based on evolving business needs. Associates may be required to perform additional duties as assigned.

Here at Prompt, we are committed to fostering a fair and respectful work environment. As part of this commitment, it is our policy not to hire individuals from Prompt Customers unless they have obtained their current employer's explicit consent. We believe in upholding strong professional relationships and respecting the agreements and commitments our customers have with their employees.

We appreciate your understanding and cooperation regarding this policy. If you have any questions or concerns, please don't hesitate to reach out to our HR department.

Prompt Therapy Solutions, Inc is an equal opportunity employer, indiscriminate of race, color, religion, ethnicity, ancestry, national origin, sex, gender, gender identity, sexual orientation, age, marital status, veteran status, disability, medical condition, or any other protected characteristic. We celebrate diversity and are committed to creating an inclusive environment for all employees.