Administration - Billing Specialist

GENERAL DESCRIPTION

Responsible for collecting, posting and managing account payments. Responsible for submitting claims and following up with insurance companies.

ESSENTIAL DUTIES

Adheres to the policies, operating procedures, the Mission and Core Values of Omega Senior Living.

Prepares and submits clean claims to various insurance companies either electronically or by paper.

Answers questions from patients, clerical staff and insurance companies.

Identifies and resolves patient billing complaints.

Prepares, reviews and sends patient statements.

Evaluates patient’s financial status and establishes budget payment plans.  Follows and reports status of delinquent accounts.

Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor.  Prepares information for the collection agency.

Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.

Processes payments from insurance companies and prepares a daily deposit.

Conducts self in accordance with employee manual.

Maintains strictest confidentiality, adheres to all HIPAA guidelines/regulations.

Will keep certification current and participate in continuing education to include staff meetings, in-services and web based trainings.

This is an overview of the Job Description and not a comprehensive list of responsibilities.  An associate shall perform all duties as assigned.

EDUCATION

High school diploma or GED required.

EXPERIENCE

Knowledge of medical billing/collection practices, computer programs, business office procedures, basic medical coding and third-party operating procedures and practices.  Ability to operate a computer, basic office equipment and multi-line telephone system. 

SPECIFIC REQUIREMENTS

Must be able to read, write, speak, and understand the English language.

Requires attention to detail and the ability to follow instructions.

Must be able to maintain a professional appearance during their shift.

Resident care philosophy with a focus on providing the highest level of quality service and professional interaction.

Must possess the ability to make independent decisions when circumstances warrant such action and to remain calm during emergency situations.

Must possess the ability to deal tactfully with personnel, residents, family members, visitors, and the general public.

Must be knowledgeable of administrative practices, procedures, and guidelines.

Must possess a cheerful personality and be able to work harmoniously with other personnel.

Must possess the ability to minimize waste of supplies, misuse of equipment, etc.

Must possess the ability to seek out new methods and principles and be willing to incorporate them into existing practices.

Must be able to follow written and oral instructions.

Must have a working knowledge of computers, input/output/retrieval data, etc.