Billing Representative - Future Candidates

Duties and Responsibilities:

• Follow detailed instructions on claim processing projects
• Research, process and follow up on claim re-submittals
• Research and resolve billing problems or issues
• Maintain operational integrity by following policies and procedures; but also suggesting process
• improvements that will benefit patients, clinicians, colleagues and overall operations
• Commanding understanding of Carbon’s payers and their policies, payer portals, billing hub, and waystar
• Multi-tasking with all the above

Job Required Qualification:

• 3 to 5 years of US Healthcare Experience with the Knowledge & Skills required 
• 3 years experience in US Health care handling – Physician, Outpatient Claims,
• Understanding and validation of patient eligibility, knowledge of CPT codes, DX codes, NPI
• numbers, Revenue codes, and Provider Tax IDs.
• Proficient in Denial and Rejection handling
• Experience to handle Multiple Providers’ Claims,
• Experience handling Medicare and Medicaid Claims – Establishing Patient Eligibility
• Knowledge in Patient Demographics,
• Coordination of Benefits, Knowledge of Primary Rules and Determinations
• Knowledge of all Provider types – such as, Billing Provider, Referring Provider, Rendering Provider
• Knowledge of Medical Terminology, Basic Anatomy and Physiology
• Ability to multi-task with all of the above
• Familiarity with Google Suite apps and working knowledge of Excel
• Must have the ability to remain focused and calm during stressful situations
• In depth knowledge of how US health insurance works
• Must have the ability to speak, read, and write in English clearly and professionally
• Possess strong organizational skills and prioritization

Travel Required:     0 – 10%  

Language Skills  

Must be able to communicate effectively in English.  Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals.  Ability to write routine reports and correspondence.  Ability to speak effectively before groups of customers or employees of the organization.  

Physical Demands  

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodation may be made to enable individuals with disabilities to perform essential functions.