Billing Specialist

The Billing Specialist generates insurance claims and patient statement billings and collects outstanding insurance or patient balances.

Essential Functions

• Makes follow-up phone calls on accounts with outstanding balance
• Maintains standards to ensure systematic, consistent and timely collection follow-up
• Follow-up on accounts with outstanding balances that do not have appropriate payment arrangements
• The Aged Trial Balance report will be printed every other week and every outstanding account should be worked
• All notes regarding written and/or verbal communication on the account will be maintained in the “MEMO” file on the patient’s account and should include the following:
  • Date of collection work
  • Time of collection work
  • Telephone # of contact
  • Full name of contact
  • Location of contact (home, work, employer, insurance co.)
  • Complete summary of conversation
  • Next follow-up date based on payment promises
  • Collector’s initials
• Prior to sending accounts to a collection agency for follow-up, dates for all patient statements should be documented in the “MEMO” file. (refer to the batch statement record to obtain statement billing dates)
• Insurance Due Accounts should have the initial follow-up call made 30 days following the date of service. Subsequent follow-up calls should be made every 14 days until the balance is paid.  Insurance Due balances not paid within 90 days from date of service will be transferred to patient due and billed to the patient
• Patient Due Accounts should have the initial follow-up call made 14 days following the date of service. Subsequent follow-up calls should be made every 14 days until the balance is paid or until adequate payment arrangements are made according to the Prompt Pay Discount policy (FIN04.08).  Patient due balances aged 60 days that do not have adequate payment arrangements will be sent to a collection agency for follow-up.  Any uncollected balances aged 180 days that do not have payment arrangements made will be written off as bad debt in accordance with the Bad Debt Write-off policy (FIN04.12)
• All Outstanding Accounts aged 120 days without appropriate payment arrangements will be sent to a collection agency. Any uncollected balances aged 180 days that do not have payment arrangements made will be written off as bad debt in accordance with the Bad Debt Write-off policy (FIN04.12).   The following information should be included with the accounts when sent to the collection agency:
  • Print screen of all collection memos
  • Print screens of patient demographics, billing data, insurance verification/authorization information, statement dates, etc
• Patient Statements will be generated on a 14 day cycle. Statements should be printed every Thursday evening and mailed out the following morning

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.

The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.

The employee must be able to stand and/or walk at least five hours per day.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.