Billing Specialist

Responsibilities

• Responsible for claim review and submission to Medicare, Medicaid, commercial and private insurance payers. Verifies accuracy and completeness of all required information prior to submission.
• Follows up with insurance companies on unpaid or rejected claims. Resolves issues and resubmits claims.
• Reads and interprets insurance explanation of benefits. Maintains specialized knowledge in insurance processes and guidelines, including authorizations and limitations.
• Investigates insurance claim denials, exceptions, or exclusions. Takes necessary action to resolve claim and payer issues in an effort to recover proper reimbursement.
• Provides customer service relating to all billing inquiries and complaints. Able to explain insurance processes, benefits, and exclusions. Follows HIPAA guidelines in handling customer information.
• Performs other billing duties as requested by the Billing Supervisor, Billing Manager, or Director of Billing.
• Qualifications/Education:
• Must have a high school diploma, college degree preferred, not required.
• Six months to one year of related experience and/or training; or equivalent combination of education and experience.
• Proficient in use of computers and software including, but not limited to: practice management software, word processing and spreadsheet applications.
• Detail oriented with ability to multi-task.
• Manages one's own time with minimal supervision.
• Strong mathematics and problem-solving skills.
• Seeks and shares pertinent information related to insurance or internal processes.
• Communicates effectively both verbally and in writing to convey and receive information.
• Use logic and reasoning to identify the strengths and weaknesses of alternative solutions, conclusions or approaches to problems.
• Self-evaluates performance to make improvements or take corrective action. Consider the relative costs and benefits of potential actions to choose the most appropriate one.
• Use equipment, facilities, and materials appropriately as needed to do certain work.
• This position must commit to 9 months in the role before applying for alternative roles within the organization. Exceptions must be approved by Department leadership.
• Dimensions:
• Physical Demands
• Regularly required to sit, stand, walk, and occasionally bend and move about the facility.
• Infrequent light physical effort required.
• Occasional lifting under 10 lbs.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
• Working Conditions
• Work performed in an office environment,
• Special Factors
• This role can be performed remotely.
• Beware of scams online or from individuals claiming to represent Convatec
• A formal recruitment process is required for all our opportunities prior to any offer of employment. This will include an interview confirmed by an official Convatec email address.
• If you receive a suspicious approach over social media, text message, email or phone call about recruitment at Convatec, do not disclose any personal information or pay any fees whatsoever. If you're unsure, please contact us at careers@Convatec.com .
• Equal opportunities
• Notice to Agency and Search Firm Representatives

Benefits

Additional Information

About Convatec Pioneering trusted medical solutions to improve the lives we touch: Convatec is a global medical products and technologies company, focused on solutions for the management of chronic conditions, with leading positions in Advanced Wound Care, Ostomy Care, Continence Care, and Infusion Care. With more than 10,000 colleagues, we provide our products and services in around 90 countries, united by a promise to be forever caring. Our solutions provide a range of benefits, from infection prevention and protection of at-risk skin, to improved patient outcomes and reduced care costs. Convatec's revenues in 2024 were over $2 billion. The company is a constituent of the FTSE 100 Index (LSE:CTEC). To learn more please visit http://www.convatecgroup.com Position Overview: Performs accounts receivable functions including billing, pursuing reimbursement, customer service, and record keeping

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