Summary

The Billing Specialist performs a variety of functions within the billing process, in a timely and efficient manner, that includes statements, correspondence, refunds, denials, re-bills, collections, and customer service. These functions may be performed using manual/paper processes or electronically.

Qualifications

• High School Diploma or equivalent required
• Medical coding (ICD-10, CPT, HCPC) knowledge preferred
• Medical claim filing and processing knowledge preferred, including electronically
• Minimum one (1) year office experience required, preferably in a medical billing environment
• Experience and proficiency with accounting software, PC computer including word processing and spreadsheets, and 10-key calculators
• Strong math, analytical, and data entry skills required
• Strong problem-solving and decision making skills required
• For hospital settings, additional requirements may apply and change without notice, including, but not limited to, criminal background check, health clearance and hospital compliance training
• Successfully pass Company pre-employment drug test and periodic and random thereafter
• Demonstrated and proven ability/experience in accomplishments in all of our five core values:

*Shine

*Team

*Accurate

*Respect

*Standardize

Essential Functions

Under direct supervision, and in accordance with Company policies, procedures and guidelines, this position:

• Prepares, verifies, electronically submits or mails periodic billing statements to customers/clients in a timely manner ensuring accuracy in data
• Electronically sends out patient statement files to POH as applicable
• Processes payments to customer accounts ensuring accuracy
• Reconciles and posts electronic payments from insurance carriers as applicable
• Investigates and resolves rejected/denied claims and resubmits for payment to insurance provider and/or patient
• Reviews and responds to correspondence in accordance with company policies and procedures
• Provides customer service regarding billing/pricing issues/questions
• Responds to and resolves issues for customers in a timely and efficient manner
• Performs sorting, filing, typing, photocopying and data entry as required
• Performs account collection activities as required
• Assists in the preparation of reports as required
• Balances un-posted daily cash reports as applicable
• Acts as backup for handling incoming calls
• Adheres to confidentiality, safety, compliance, and legal requirements
• Maintains consistent and reliable attendance and complies with company guidelines on attendance
• Performs other duties as assigned

Physical Demands

• Occasional carrying, pushing, and pulling of objects; and lifting of up to 20 lbs may be required
• Occasional reaching, stopping, bending, kneeling, and crouching
• Frequent prolonged standing/sitting/walking
• Must be able to see, hear, and respond adequately
• Extensive computer work
• Frequent use of telephone

Working Conditions

• Air conditioned office
• Subject to electrical and radiant energy hazards
• Sufficient noise and interruptions to cause distractions
• Frequent exposure to video display terminals
• May be asked to work occasional irregular or extended hours

Skills/Abilities/Competencies

• Perceive pertinent details and verbal or tabular material
• Ability to see things from the customer's/patient's point of view and respond in a timely appropriate and courteous manner
• Handle emergency situations with calmness and professionalism
• Ability to work effectively with others and promotes positive working relationships
• Perform arithmetic operations quickly and accurately
• Understand meaning of words, ideas associated with them and their effective use
• Understand instructions, reason, and make judgments
• Effective oral and written communication skills, excellent organizational and interpersonal skills, and computer literacy required
• CUSTOMER-FOCUSED: Aware of customer needs; makes decisions with customer in mind; builds strong customer relationships.
• COMMUNICATOR: Proactively conveys a clear, convincing, and timely message; possesses strong verbal, written, and presentation skills.
• PROBLEM SOLVER: Uses data and logic to quickly find solutions to difficult challenges.
• BUSINESS SAVVY: possesses business and organizational know-how; understands how to accomplish tasks through formal channels and informal networks.
• RESOURCEFUL: Knows how to get what is needed; manages time and workloads for maximum efficiency.
• QUALITY CONSCIOUS: Delivers accuracy and precision in work products; mindful of technical requirements, rules, and standards.
• TIME-WISE: Prioritizes; respects others' time; adheres to schedules and agendas.
• COLLABORATIVE: Works effectively with others to accomplish goals