Billing Specialist I - PB

About the role

Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri. No matter where you start with us, we’re committed to taking our team to the top. If you’re ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family.

General Summary The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts. Reports to the Billing Supervisor.

At Phelps Health, we think we have a better team, benefits, and opportunities for growth than anyone else around, and we invite you to see for yourself!

Responsibilities

• Enters information necessary for insurance claims such as patient, insurance, and insurance ID.
• Insures claim information in complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
• Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
• Follows HIPAA guidelines in handling patient information.
• May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• Understand managed care authorizations and limits to coverage such as number of visits