Billing Specialist

Position Summary:  The Billing Specialist position reports directly to the Director of Finance and will work within a team environment to complete the submissions, follow up rejections and posting payments for Medicaid, Medicare and other third party payers.

Qualifications & Education Required:

• High school diploma or the equivalent
• Knowledge of LTC/Skilled Nursing third party billing preferred
• Must have computer literacy and math aptitude, and the ability to use 10-key calculator, computer key board, and basic software applications, including Excel, Word, and Outlook.
• Three years minimum experience in a healthcare facility, healthcare business office, physician's office, or insurance billing environment.
• Good oral and written communication skills
• Ability to interact with elders and care for their needs
• Willingness to embrace and exemplify St. John’s Brand Characteristics
• customer service skills 

Core Organizational Competencies:

• St. John’s Brand Characteristics - Embrace living by being Friendly, Respectful, Responsive, Compassionate, Innovative and Fun towards elders, families and colleagues.  
• Teamwork - Actively participates. Assists team members; offers encouragement. Acknowledges/welcomes elders. Keeps team members informed. Recognizes achievements and efforts of others. 
• Job Knowledge - Consistently demonstrates working knowledge of all aspects of job. Remains current on job related changes and trends.
• Planning/Organization - Demonstrates initiative; plans appropriately. Uses time, materials, resources effectively. Organizes work to ensure commitment and priorities.
• Productivity - Consistently maintains high activity and efficiently produces acceptable volume of work. Consistently meets deadlines and commitments.
• Quality - Consistently produces accurate, timely work which meets required quality standards. Pays attention to detail. Sets high standards of performance for self and actively seeks continuous improvement. Provides elder-driven care.
• Reliability - Consistently delivers on commitments. Can be counted on to accomplish tasks without follow up. Available when required by elder or team and can be counted on to help or assist when needed. Responds in a timely manner.
• Demeanor (attitude) - Embraces change with optimism. Addresses concerns appropriately. Positively communicates. Good listener. Consistently maintains a positive demeanor.

Position Competencies:

• Knowledge of medical billing and collection practices;
• Keeps current with and effectively applies new billing requirements to complete billing properly
• Demonstrates a clear understanding of billing procedures; complies with and applies billing policies and procedures appropriately
• Plans, prioritizes, and organizes work effectively to produce measurable billing results
• Monitors and checks work or information and plans and organizes time and resources efficiently
• Technical expertise in all forms of medical billing, including Medicaid, Medicare and other third party payers

Position Responsibilities:

• Prepares and submits timely clean claims to various insurance companies either electronically or by paper
• Verifies completeness and accuracy of all claims submitted;
• Timely follow up on denials, exclusions and exceptions;
• Meet all required billing and department deadlines;
• Utilize monthly aging accounts receivable report to follow up on unpaid claims including but not limited to performing various collection actions including contacting insurers by phone, correcting and resubmitting claims to payers;
• Regularly meet with Director to discuss and resolve reimbursement issues or billing obstacles;
• Regularly attend staff meetings;
• Help with other duties as needed that support the Core Team to fulfill St John’s mission vision and values

Physical Requirements:

• Requires frequent sitting, standing, twisting, stooping, handling, bending and walking associated with a normal office environment. Manual dexterity needed for using a calculator and computer keyboard.

Exposure to Conditions:

• May be exposed to infectious diseases. Exposed to physical aggression.