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Billing Specialist

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Denver, CO
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Job Location:
Denver, Co 80112
Accounting and Auditing Services
Job Type:
Full Time
Years of Experience:
1 to 2 Years
Education Level:
High School or equivalent
Career Level:
Entry Level
Job Referenc Code:
**MEMBERS ONLY**SIGN UP NOW***., Inc. is a privately held Specialty Infusion company focused on providing complex pharmaceutical products and clinical services to patients outside of the hospital. This market is expanding rapidly and is driven by increasing healthcare costs that are moving patients into the most cost effective delivery settings, a growing bio-pharmaceutical pipeline of infuseable and injectable medications, an aging population and the recent addition of a Medicare benefit for these products and services.
Billing Specialist
The Billing Specialist is responsible for a broad range of billing processes related to medical accounts receivable in support of single or multiple site locations. The employee will proactively work assigned payer billing to maximize accurate and timely payment. The employee will observe company policies and all applicable laws and regulations regarding the billing of medical claims. The employee must have the ability to prioritize, problem solve, and multitask. The employee will work closely with other staff to identify, resolve, and share information regarding payer trends and guideline updates. Above all, qualified candidates should possess exceptional internal and external customer service skills and actively promote **MEMBERS ONLY**SIGN UP NOW***.’s company culture.
Essential Duties and Responsibilities:
 Insures daily accomplishments work towards company goals for cash collections and A/R over 90 days
 Understands and adheres to state and federal regulations, and to company policies regarding to compliance, integrity, patient privacy and ethical billing practices
 Understands and adheres to HIPAA and PHI guidelines
 Bills delivery tickets, secondary claims and/or patient statements in a timely manner; makes necessary demographic changes to patient accounts to insure future collections
 Resubmits accurate and timely claims in formats including but not limited to CMS-1500, electronic 837 and electronic NCPDP
 Conducts billing utilizing most efficient resources to secure timely payment of open claims or invoices; electronic solutions should be given priority
 If applicable, will secure payments prior to delivery or arrange for payment at time of service
 Identifies patterns of non-compliance by branch staff in completing patient registration, supporting billing documentation and delivery tickets
 Reviews delivery tickets for accuracy and completes claims per payer specific guidelines
 If applicable, submits secondary billing in a timely manner with appropriate supporting documentation per payer specific guidelines to insure expected revenue is allowed
 Researches websites of assigned payers to bill for payer updates and shares updates accordingly
 Communicates consistently and professionally with other **MEMBERS ONLY**SIGN UP NOW***. employees
 Works within specified deadlines and stressful situations
 Works overtime when necessary to meet department goals and objectives
 Performs other tasks or special projects as requested by management
Knowledge and Skill Requirements:
 A minimum of 1-2 years experience in medical billing with a working knowledge of managed care, commercial insurance, Medicare and Medicaid reimbursement; home infusion experience a plus
 Working knowledge of automated billing systems, experience with CPR preferred
 Working knowledge and application of metric measurements, basic accounting practices, ICD-9, CPT and HCPCS coding
 Solid Microsoft Office skills required: Word, Excel and Outlook
 Ability to type 40 wpm and proficiency with10-key calculator
 Ability to independently obtain and interpret information
 Strong verbal and written communication skills
Education/Licenses/Certificates required:
 High School diploma or GED equivalent required.
 Some college a plus
: Billing
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