[Remote] Billing Specialist
Note: The job is a remote job and is open to candidates in USA. Surpass Behavioral Health is a rapidly growing national Specialty Pharmacy focused on providing services to patients with chronic and rare illnesses. The Billing Specialist will assist the billing team in ensuring accurate billing, timely submission of claims, and resolving billing-related issues.
Responsibilities
- Perform pre-bill review to ensure that authorization is documented where necessary
- Ensure that coding on claims follows payer guidance
- Ensure accurate billed and expected charges do not exceed usual and customary or contractual pricing where indicated
- Create and submit primary and secondary pharmacy and medical claims promptly
- Reviewing and identifying claims pricing discrepancies based on updates/changes to fee schedules
- Communicate any billing-related issues to all appropriate departments
- Ensure coding to the highest level of specificity and for maximum reimbursement by third-party payers
- Maintain current knowledge of departmental and organizational policies
- Support billing staff in training and ongoing education when required
- Consistently professionally represents the company
- Maintains effective working relationships and cooperates with all personnel in the Company
- Adheres to the Company’s compliance requirements as stated in the policy and procedure manual and all other related policies
- Performs other duties and responsibilities as assigned
Skills
- Provide the highest level of professionalism, responsiveness, and communication
- Must possess the ability to multi-task and frequently change direction
- Proficient in the use of a computer and other devices
- High school diploma or GED
- Ability to work independently and within a multidisciplinary team
- Basic math, bookkeeping, and accounting skills
- 1-3 years of experience in medical billing
- Understanding of industry-specific policies, such as HIPAA regulations for healthcare
Company Overview