BILLING SPECIALIST - FULL TIME

Principal Functions And Responsibilities

• Fulfills departmental policies and procedures, objectives, and Quality Improvement and Safety programs.
• Handles payer-specific caseloads such as Medicaid, Commercial, etc.
• Explains charges, services, and hospital policies to patients and guarantors regarding payment.
• Serves as relief for Admitting Clerk and Emergency Registration when needed.
• Bills primary payers electronically and files secondary claims.
• Reconstructs claims and makes inquiries to payers to reconcile patient accounts.
• Works on denied claims, A/R reports, and prepares corrections for review.
• Prepares accounts for adjustments and reviews them with the Business Office Manager.
• Enhances professional growth through educational programs, meetings, and workshops.
• Maintains positive relations with co-workers, other departments, patients, and visitors.
• Identifies and communicates opportunities for system or process improvement.
• Performs other duties as assigned.
• May work overtime or weekend shifts.
• Maintains confidentiality in matters related to patient/family.
• Provides information to patients and families to reduce anxiety and convey a caring attitude.
• Maintains professional relationships and conveys relevant information to the healthcare team.

Qualifications

• High School diploma or equivalent.
• At least 1-year billing experience in a hospital or clinic setting.
• General knowledge and understanding of CPT, ICD-9 and ICD-10 codes, revenue codes.
• Knowledge of UB and HCFA billing.
• Critical Access Hospital (CAH) and Rural Health Clinic knowledge.
• Effective communication skills with co-workers, insurance companies, etc.