JOB DESCRIPTION

POSITION TITLE Billing Specialist

DEPARTMENT Finance

REPORTS TO Billing Office Supervisor

SUPERVISES None

CLASSIFICATION Non-exempt

POSITION SUMMARY

Responsible for processing and preparing field documentation in order to bill the appropriate payor for services rendered.

JOB DUTIES AND RESPONSIBILITIES

1. Prepare documentation for mailing.
2. Make pay-source changes and add proper information.
3. Data enter information changes as required.
4. Process/submit TARS
5. Verify coverage eligibility.
6. Review ICD-9 codes and correct as needed.
7. Check documentation for medical justification.
8. Identify and refer past due accounts to the Business Office Manager.
9. Follow-up all accounts Aging Reports.
10. Assist customers requiring payment schedules.
11. Responsible for processing mail returns.
12. Responsible for status letters.
13. Responsible for all verbal and written billing inquiries.
14. Research to complete documentation.
15. After completing research, route incomplete documentation to Business Office Manager.
16. Establish proper paying party and verify coverage eligibility.
17. Establish proper pricing for procedures completed.
18. Acquire authorization, verification, and purchase orders from third party payors.
19. Research unidentified customers to whom services were provided.
20. Complete medical justification documentation.

AUTHORITY

Financial Authority

1. May requisition supplies through the immediate supervisor
2. May not purchase or authorize purchase of inventoried items.
3. May authorize payment plans of patient’s account up to 18 months without charging interest.
4. May not make contracts on behalf of the company.

Human Resources

1. May not request hiring of employees for current/new positions.
2. May not discipline employees
3. May not approve schedules, AWR’s, Leaves of Absence, changes to workweek.

 Communication

1. May not release employee-related information.
2. May release call related information if the proper authorization has been submitted.
3. May not release Company information.
4. May use Company letterhead only for business related matters.
5. May not communicate to the media.

 MINIMUM QUALIFICATIONS

1. High School diploma or GED.
2. Medical billing experience/education preferred.
3. Good organizational skills.
4. Good verbal, written and reading comprehension skills.
5. Basic computer skills.

KEY PERFORMANCE MEASUREMENTS

Sentinel > 1 missing ticket at month end

Sentinel any ended account or account at 120 days

Frequency Keying errors

Frequency Adjusted collection rate

Frequency Pay source changes > 10%

Frequency Data entry time

ESSENTIAL POSITION REQUIREMENTS

Equipment Demands

Must be able to operate the following equipment:

1. Basic office equipment

Emotional Demands

1. Work with tight deadlines under pressure.
2. Work with many different agencies/companies.
3. Work closely with the public
4. Be confidential with privileged information.

Physical Demands

1. Able to perform general office duties.
2. Must be able to work while sitting for prolonged periods.
3. Able to lift a 30 lbs. Box to a height of three feet.
4. Must be able to type >/= 30 wpm.

Environmental Demands

1. Must be able to work indoors.
2. Must be able to work normal business hours.