Revenue Cycle Billing Specialist
Business Services Department
1.0 FTE, 80 Hours a Pay Period
Days, Hours between 7:30 am – 4:00 pm
Weekends: No
Holidays: No
Telecommute Available: Partial

Position Overview:

The Revenue Cycle Billing Specialist is responsible for correcting claim errors and completing claim submission process for all payers. Duties include but are not limited to: validating registrations, obtaining accurate insurance information to coordinate benefits, answer incoming calls, data entry, and providing process improvement ideas for issues identified in the claims submission process. They will analyze, research, and prepare insurance claims to be submitted to insurance carriers timely and accurately in the patient accounting system.

Essential Duties & Responsibilities:

1. Reviews daily registration report, claim validation reports, and encounter holds to guarantee early turnaround of accounts receivable.
2. Reviews patient access, extended business office, and insurance requests for validation of insurance coverage for patients dates of service.
3. Monitors claim files that are processed at clearinghouse, logs any issues with claims file to either clearinghouse or patient accounting system for timely resolution of issues.
4. Reviews incomplete, on-hold, and rejected claims in clearinghouse to ensures claim accuracy and completeness.
5. Determines appropriate Winona Health staff to correct billing errors based on standard work. Monitors outstanding claims in clearing house when follow up is needed outside of Business Services Department to correct claim.
6. Prints paper claim forms from clearinghouse and mails with appropriate documentation in a timely manner.
7. Answers incoming calls to the business office main number and responds to all phone inquires and correspondence in an efficient and effective manner, documenting activity within patient accounting system.
8. Triages issue and completes appropriate action for a positive interaction with customer.
9. Logs patient complaints as needed or escalates calls to manager/director as appropriate.
10. Performs tasks to support the department including processing and routing all incoming and outgoing mail for department. Back up for ordering of office supplies and keeping office equipment in working order.
11. Other job duties as assigned.

Essential Skills and Experience:

1. Associates Degree in related field of study or equivalent work experience
2. Basic computer skills: Microsoft Word, Excel, Outlook, etc.
3. Ability to read and interpret documents such as regulatory and standard work manuals
4. Ability to create and maintain routine reports and correspondence
5. Math skills that encompass the ability to compute rates, ratios, and percentages
6. Must possess effective customer service oriented communication skills

Internal Applicant Policy:

It is the policy of Winona Health to work with employees in an equitable fashion regarding promotions, transfers, and position reclassifications.
 
Any employee wishing to apply for another available position at Winona Health must submit an application for consideration through the internal application portal. Employees requesting to change positions should have successfully completed at least six (6) months in their current position. Employees currently in the formal disciplinary process may be required to meet with the Director of Human Resources to determine eligibility to request transfer. The employee’s past performance, experience, training and qualifications will be considered in transfer/hiring decisions. Consideration for transfer or promotion is not a guarantee of transfer or promotion. Employees may be given a chance to interview for a position when they meet the minimum position qualifications.

Disclaimer:

Winona Health is an equal opportunity employer. Winona Health does not refuse to hire, discharge, or discriminate against a person with respect to tenure, compensation, terms, upgrading, conditions, facilities, or privileges of employment because of race, color, creed, religion, sex, age, national origin, marital status, genetic information, status with regard to public assistance, membership in a local discrimination commission, sexual orientation, disability, veteran status, or any other prohibited basis of discrimination under applicable local, state, or federal law. Winona Health does not tolerate retaliation against any employee, patient/resident, physician, or other individuals pursuing concerns regarding Civil Rights issues. Winona Health adheres to ALL pertinent governmental policies and legislation including the Civil Rights Act of 1964, Title VII, as amended, and the Minnesota Human Rights Act.