Job Description

The Charges and Claims Specialist is responsible for managing the Initial creation of claims and their submission to Insurance, or designation of patient responsibility. Submission of claims, handling patient and insurance communications as well as any additional tasks needed.

ESSENTIAL FUNCTIONS

• Review all claims that have been created by Providers billing.
• Communicate any billing errors to providers for clarification prior to submission to insurance or billing to patients.
• Communicate any Demographic errors with appropriate office staff prior to submission to insurance or billing to patients.
• Prepare and submit clean insurance claims daily for all services provided electronically and manually.
• Submit electronic Claims to Insurance Daily.
• Work any claims electronically rejected by the clearinghouse or the insurance company

EDUCATION and/or EXPERIENCE

• High school diploma or equivalent 
• Minimum 2-3 years of experience in medical billing 
• Experience with practice management systems and EHR platforms 
• Familiarity with medical terminology and CPT/ICD-10 codes 
• Familiarity with Microsoft applications, including, but not limited to Word and Excel.

KNOWLEDGE AND SKILLS

• Strong knowledge of medical insurance plans (commercial, Medicare, Medicaid, Tricare) 
• Knowledge of basic medical coding and third-party operation procedures and practices.
• Excellent communication and customer service skills 
• Strong written and verbal communication skills including the ability to confidently speak to patients
• Excellent organizational skills to manage multiple tasks throughout the day.

ABILITIES

• Ability to operate a multi-line telephone system and answer a telephone in a pleasant and helpful manner.
• Demonstrate the ability to work as a team player in a very cohesive medical practice.
• Ability to communicate and work well with co-workers. Open and honest communication.
• Ability to effectively communicate orally and in writing with internal and external business professionals.
• Must be responsible, reliable, and able to carry out job functions

Total Rewards

The referenced base salary range represents the low and high end of Specialty Care Networks’ salary range for this position. Some candidates will not be eligible for the upper end of the salary range. Exact salary will ultimately depend on multiple factors, which may include the successful candidate’s geographical location, skills, work experience, market conditions, internal equity, responsibility factor and span of control, education/ training and other qualifications. Specialty Care Network offers a total rewards package that supports our employee’s life, career and retirement.