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Billing Specialist

Company: Kforce Finance and Accounting
Location: Rockville
Posted on: June 17, 2022

Job Description:

RESPONSIBILITIES:Kforce has a client in Rockville, MD that is seeking a Billing Specialist.


  • In this role, the Billing Specialist analyzes, investigates and resolves account issues, including resubmitting and updating lien and claim document information
  • Accesses available resources, such as the Membership System, Resolute, Diamond payer databases to locate missing or incorrect information
  • Updates medical claims with corrected billing information and releases claims for transmission to the payer
  • Investigates and documents actions taken to resolve medical billing discrepancies and unusual charges and credits
  • Performs follow-up collection activity/ negotiation of lien settlement via pre-assigned work queues to expedite payments
  • Works high priority TPL/MVA/WC cases according to department policies and procedures
  • The Billing Specialist conducts research to make the determination of related (NON-Plan Services) paid claims for subrogation cases, which includes identification and validation of Third Party Liability/MVA /WC claims cost avoidance opportunities
  • Receives and responses to incoming correspondence and calls pertaining to TPL/MVA/WC verification, billing and collections inquiries from various sources
  • Evaluates case status based on established criteria, and takes appropriate action to maintain productive and proactive communication with the third party
  • Ensure that all appropriate patient service charges are entered into the billing system
  • As a Billing Specialist, this role provides feedback and education to Financial Coders regarding coding and billing edits
  • Performs other duties as directed
    Job Requirements:REQUIREMENTS:
    • High School diploma or GED required; AA or BS preferred
    • Coding certification preferred
    • Medical billing/coding/collection experience
    • Experience with Third Party Liability/Attorney collections
    • Experience with/knowledge of Workers Compensation and Third-Party Liability/MVA billing and collection; Procedures and regulations
    • Knowledge of compliance medical and insurance terminology
    • Knowledge of Microsoft Word, Excel, and Access is preferred
    • Proficient with MS Office Suite
    • Good communication skills
    • Good customer service skills
    • Able to work in a confidential environment

      Kforce is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, pregnancy, sexual orientation, gender identity, national origin, age, protected veteran status, or disability status.

Keywords: Kforce Finance and Accounting, Rockville , Billing Specialist, Accounting, Auditing , Rockville, Maryland

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