What are the responsibilities and job description for the Billing Specialist - 7AM - 3:30PM or 8:00AM - 4:30PM position at Bothwell Regional Health Center?
Fulltime
Benefits: Health Insurance, Paid Time Off, Extended Sick Leave, Retirement -403B, hospital matches up to 4%, Employee Pharmacy, Vision Insurance, and Dental Insurance
JOB SUMMARY:
The Hospital Billing Specialist is responsible to bill all third party payers electronically and is responsible to follow through on an account to a zero balance by following all rules and regulations both local and national in a timely manner.
The Hospital Billing Specialist reports to the Billing Specialist Supervisor who then reports to the Director of Financial Services.
QUALIFICATIONS:
Education:
High School graduate with related subjects in general business.
Computer knowledge
Some experience in billing is desirable.
Good customer service skills.
Medical Terminology.
Licensure/Certification:
a.) N/A
Work Experience:
Minimum 1 yr. hospital billing experience preferred.
Three years’ experience in collections, customer service and insurance claim processing preferred.
Ability to operate various office machines.
Strong knowledge of the Medicare/Medicaid regulations as they pertain to billing claims.
Be able to work independently and make reasonable decisions while maintaining confidentiality.
RESPONSIBILITIES/JOB DUTIES:
Working daily reports as assigned.
Billing all primary & secondary claims electronically.
Maintain minimal unbilled AR at end of every month under $200,000.00 in charges.
Work remittance advices for denials and possible re-submission.
Follow up with insurance payers on claim resolution. Accounts should be resolved in a timely manner.
Communicate and work with all clinical departments to insure proper charging and billing of accounts.
Respond to patient phone inquiry as needed. Reconcile the account and understand what the balance consists of (i.e. deductible, co-insurance, co-pay, etc).
Review account for all possible sources of payment including third party liability.
Process credit balances as assigned by your work group.
Work all correspondence and respond promptly and provide requested information to ensure timely resolution.
Inform Supervisor of any problems or changes in payer requirements and exercise independent judgment to analyze and report repetitive denials so corrective action can be taken.
Provide the best customer service possible.
Document in Meditech system any action taken on patient’s account.
All other assigned duties which may include – sending and following up on appeals, working follow up on insurance companies, ordering claims, & balancing accounts.
REQUIRED STAFF COMPETENCIES
Demonstrates support for organizational and departmental mission.
Supports and demonstrates knowledge of the Strategic Plan and the Hospital Key Initiatives.
Fosters and promotes teamwork within department and the organization as a whole.
Works to resolves conflicts constructively and in a timely manner.
Ability to communicate effectively and simply with every customer and co-worker.
Ability to display a positive, courteous and friendly attitude toward all contacts.
Ability to build good relationships with others based upon a sustained effort of mutual support toward common goals.
Ability to exercise good judgment, reasoning and concentration to detail and to take personal accountability for all actions in carrying out job duties.
Is customer focused and committed to Quality and Process Improvement with a strong desire to provide service excellence.
Possesses and displays a strong knowledge and understanding of the standards of practice for their position including, if and when applicable, commensurate computer skills; population specific and general competencies; organizational skills, time and project management.
Possesses a vigorous and enthusiastic desire to learn and to grow both personally and professionally, and to improve one's skills in order to deliver the best possible care for our customers.
WORKING CONDITIONS:
General office setting. No exposure to extremes in temperature, lighting or noise.
Requires prolonged sitting.
Requires frequent keyboarding.
Significant time spent looking at computer monitor.
The Hospital Billing Specialist is responsible to bill all third party payers electronically and is responsible to follow through on an account to a zero balance by following all rules and regulations both local and national in a timely manner.
The Hospital Billing Specialist reports to the Billing Specialist Supervisor who then reports to the Director of Financial Services.
QUALIFICATIONS:
Education:
High School graduate with related subjects in general business.
Computer knowledge
Some experience in billing is desirable.
Good customer service skills.
Medical Terminology.
Licensure/Certification:
a.) N/A
Work Experience:
Minimum 1 yr. hospital billing experience preferred.
Three years’ experience in collections, customer service and insurance claim processing preferred.
Ability to operate various office machines.
Strong knowledge of the Medicare/Medicaid regulations as they pertain to billing claims.
Be able to work independently and make reasonable decisions while maintaining confidentiality.
RESPONSIBILITIES/JOB DUTIES:
Working daily reports as assigned.
Billing all primary & secondary claims electronically.
Maintain minimal unbilled AR at end of every month under $200,000.00 in charges.
Work remittance advices for denials and possible re-submission.
Follow up with insurance payers on claim resolution. Accounts should be resolved in a timely manner.
Communicate and work with all clinical departments to insure proper charging and billing of accounts.
Respond to patient phone inquiry as needed. Reconcile the account and understand what the balance consists of (i.e. deductible, co-insurance, co-pay, etc).
Review account for all possible sources of payment including third party liability.
Process credit balances as assigned by your work group.
Work all correspondence and respond promptly and provide requested information to ensure timely resolution.
Inform Supervisor of any problems or changes in payer requirements and exercise independent judgment to analyze and report repetitive denials so corrective action can be taken.
Provide the best customer service possible.
Document in Meditech system any action taken on patient’s account.
All other assigned duties which may include – sending and following up on appeals, working follow up on insurance companies, ordering claims, & balancing accounts.
REQUIRED STAFF COMPETENCIES
Demonstrates support for organizational and departmental mission.
Supports and demonstrates knowledge of the Strategic Plan and the Hospital Key Initiatives.
Fosters and promotes teamwork within department and the organization as a whole.
Works to resolves conflicts constructively and in a timely manner.
Ability to communicate effectively and simply with every customer and co-worker.
Ability to display a positive, courteous and friendly attitude toward all contacts.
Ability to build good relationships with others based upon a sustained effort of mutual support toward common goals.
Ability to exercise good judgment, reasoning and concentration to detail and to take personal accountability for all actions in carrying out job duties.
Is customer focused and committed to Quality and Process Improvement with a strong desire to provide service excellence.
Possesses and displays a strong knowledge and understanding of the standards of practice for their position including, if and when applicable, commensurate computer skills; population specific and general competencies; organizational skills, time and project management.
Possesses a vigorous and enthusiastic desire to learn and to grow both personally and professionally, and to improve one's skills in order to deliver the best possible care for our customers.
WORKING CONDITIONS:
General office setting. No exposure to extremes in temperature, lighting or noise.
Requires prolonged sitting.
Requires frequent keyboarding.
Significant time spent looking at computer monitor.
Salary : $200,000
