Billing Specialist

About the role

The Billing Specialist at Mahaska Health is responsible for filing clean claims to various insurance companies for all Hospital, Provider Based Clinic and Clinic services. The role involves pursuing collection of all claims until payment is made by insurance companies, maintaining current billing knowledge, and resolving patient billing complaints.

Responsibilities

• Prepares and submits clean claims to various insurance companies either electronically or by paper.
• Verifies all required information necessary to file all insurance claims and ensures they are submitted timely and correctly.
• Works with providers or hospital departments to ensure correct charges, diagnosis, and procedures are reported to insurance companies.
• Follows up on unpaid claims within the standard billing cycle timeframe.
• Identifies and resolves patient billing complaints.
• Contact insurance companies regarding any discrepancies in payment.
• Identifies and bills secondary or tertiary insurances.
• Handles all mail and correspondence appropriately and timely.
• Investigates claims involving third parties and gathers all necessary information to file hospital liens in a timely manner.
• Fills out satisfaction of liens.
• Sends letters to patients to request additional information for payment of claims.
• Handles all billing for the office including insurance, third party claims, and other types of billing matters.
• Accurately processes all claims, rejected and otherwise, on a daily basis to ensure maximum cash flow.
• Maintains up-to-date billing requirements and changes for insurance types within their area of responsibility.

Requirements

• High school diploma or GED equivalent required.
• PC proficiency and experience with IP and OP hospital insurance claims filing and reimbursement principles preferred.
• Must be able to use and operate office equipment.
• Must show proof of having completed the Mandatory Reporter course at the time of hire or attend within 6 months of the start date.
• Must adhere to all training requirements as mandated by Federal, State, and Professional licensure and regulatory standards.