Billing Specialist - Medicaid/Medicare

We need to output HTML fragment with headings for sections that have real content. Use

for section headings: About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule. We need to decide which sections apply. From posting: Under direct supervision, performs all billing and collection functions... That's description of role. Could be "About the role". Then "Principal Duties And Responsibilities" is responsibilities. Then "Education", "Experience", "Knowledge, Skills And Abilities", "Licensures, Certifications" (N/A). Then "Physical Requirements", "Working Conditions", "Conditions of Employment". Then "All roles must demonstrate GBMC Values" with values list. Then "Pay Range". Then EEO boilerplate (remove). Also "Principal Duties And Responsibilities" includes many bullet-like sentences. We need to use

• for any list of duties/requirements/benefits. So we need to convert duties into list items. Also requirements (education, experience) maybe list. Skills maybe list. We must not repeat job title as heading. No Job ID. We must not include boilerplate like EEO, values? The values are part of posting; they are substantive? They are corporate values; maybe we can include under a section? There's no specific heading for values; but we could include under "About the role" or maybe "Qualifications"? However instructions: include a section ONLY when the posting has real, specific content for it — never emit a heading followed by filler/placeholder text. Values are specific content; but we don't have a predefined heading for values. We could put them under "About the role" as a paragraph. Or we could create a custom heading? Not allowed; only allowed headings are those listed. So we must fit content into those headings. Thus we need to map: - About the role: general description (first paragraph) plus maybe values? Could include values as part of role description. - Responsibilities: list of principal duties and responsibilities. - Requirements: Education and Experience? Could be separate sections: Education, Experience? But we only have allowed headings; we could put Education and Experience under "Requirements" or "Qualifications". The instructions: Use headings for section headings (e.g. About the role, Responsibilities, Requirements, Qualifications, Skills, Benefits, Pay, Schedule). So we can have multiple of those. We need to decide which to include based on content. We have Education, Experience, Knowledge, Skills And Abilities, Licensures, Certifications (N/A - skip), Physical Requirements, Working Conditions, Conditions of Employment (maybe skip as boilerplate?), Pay Range. We should include sections for which we have real content: About the role, Responsibilities, Requirements (maybe combine Education+Experience), Qualifications (maybe Knowledge, Skills And Abilities), Skills (maybe separate?), Pay. But we must avoid thin sections. Better to combine similar content into fewer sections. Let's think: - About the role: brief description of role (first sentence(s) about performing billing and collection functions under supervision). Could also include values? Might be okay. - Responsibilities: list of duties from "Principal Duties And Responsibilities". That's a big list. - Requirements: Education and Experience (High school diploma or equivalent required; Associate’s degree preferred; Two years of medical billing experience and one year experience with electronic billing; Epic experience desired). That's specific. - Qualifications: Knowledge, Skills And Abilities (thorough knowledge..., Strong collection skills..., Strong computer skills..., Strong interpersonal skills..., Excellent verbal and written..., Strong ability to investigate..., Efficient in managing..., Ability to handle multiple claims..., etc). That's a list. - Skills: maybe we could separate computer skills etc but we already have qualifications covering skills; maybe we skip Skills section to avoid duplication. - Pay: Pay Range $19.92 - $29.87 plus note about final salary offer. - Benefits: none mentioned; skip. - Schedule: none mentioned; skip. - Physical Requirements and Working Conditions: Could be part of "Requirements" or "Qualifications"? But they are not exactly requirements; they are about physical demands. Could be included under "Requirements" as additional bullet? Might be okay but we need to avoid thin sections. Could add a short paragraph under "Requirements" after education/experience. But we must not invent sections; we can include them under existing headings if appropriate. We must remove boilerplate: cookie/navigation/legal/EEO/equal-opportunity/scam-warning, duplicated lines, application instructions. Also remove "Conditions of Employment N/A", "Licensures, Certifications N/A". Also remove "All roles must demonstrate GBMC Values" maybe we keep values as part of About the role? The values list is specific; we could include them as a paragraph under About the role. We must preserve all substantive information; do not invent or summarize away detail. So we need to keep all details from the posting, except boilerplate. Thus we need to include: - Under About the role: the initial description: "Under direct supervision, performs all billing and collection functions on account balances within assigned financial classes. Ensures timely submission of all claims and timely follow up. Posts payments in EPIC. Perform eligibility, verification and authorization requests, as needed." Also maybe include the GBMC Values description? That is a list of values with descriptions. We need to preserve that. Could be a separate section? Not allowed heading. Could be included under About the role as a paragraph after the description. But we must ensure we don't create a heading with filler. So we will not create a "Values" heading. Thus About the role will contain the description and the values list (maybe as a
  ?). Values list includes each value with description. Could be represented as
  • Respect: ...
  etc. That preserves detail. - Responsibilities: list all duties from "Principal Duties And Responsibilities". That is a long paragraph with many sentences. We need to break into list items. Each sentence or clause could be a list item. Must preserve all info. Let's extract responsibilities sentences: "Manages assigned Epic work queues daily to ensure accurate billing and expedient claims follow-up." "Claims Billing Processes Ensures timely submission of all claims within assigned financial classes." "Ensures timely follow up of all claims within assigned financial classes" "Claim Resolution Processes Investigates claim denials or rejections" "Completes functions in order to resolve claims" "Uses all available tools such as but not limited to: Online access, calling the insurance companies; working with provider representatives." "Identifies appeals" "Identifies secondary billing for accounts with secondary liability; follows-up on any unpaid balances." "Brings these claims to resolution." "Identifies patient self-pay balances and bills timely to patient/family." "Follow-ups as necessary including calling for follow up." "Process any late charge claims, claims resubmission and/or claims corrections to payors." "Enters and posts payment to patient accounts based on remittance advice review." "Reconcile accounts and ensure any underpayments or overpayments are corrected" "Responds to patient and third-party payor inquiries regarding patient accounts via e-mail, telephone, mail, and in person." "Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission." "Maintain detailed and accurate billing records for auditing purposes and compliance with industry regulations" "Maintain thorough records of all communication with insurance providers and patients regarding claims." "Participate in meetings with Provider Reps to resolve denial discrepancies" "Prepare and submit appeals for denied claims." "Understanding of additional documentation necessary to submit an appeal" "Obtain an in-depth understanding of hospice billing regulations." "Ensure compliance with federal, state and local billing laws, including HIPAA regulations." "Prepare reports to managers recommending accounts for bad debt adjustments." "Maintaining lost revenue at a level of less than 1% of net healthcare revenue" "Recommends accounts for transfer to bad debt." We need to keep each as list item. - Requirements: Education and Experience plus maybe Physical Requirements and Working Conditions? Let's see. Education: "High School diploma or equivalent required. Associate’s degree preferred." Experience: "Two years of medical billing experience and one year experience with electronic billing. Epic experience desired." Physical Requirements: "Ability to sit, concentrate and pay close attention to detail" Working Conditions: "Normal office environment with little exposure to excessive noise, dust, temperatures and the like" Conditions of Employment: N/A (skip) We could include Physical Requirements and Working Conditions under Requirements as additional list items. - Qualifications: Knowledge, Skills And Abilities list. Let's extract that paragraph: "Thorough knowledge and understanding of medical billing, insurance and private pay. Knowledge of all medical billing requirements for Medicare, Blue Cross, Medical Assistance, Commercial insurance, and HMO carriersStrong collection skills, including claims follow-up, revenue cycle practicesStrong computer skills, including EMR knowledge and Microsoft Office. Excel preferred.Strong interpersonal skills Excellent verbal and written communication skills for interacting with patients, families, insurance companies and healthcare providers.Strong ability to investigate issues, find solutions, and work under pressure to resolve billing issues.Efficient in managing multiple tasks, prioritizing, and ensuring deadlines are met.Ability to handle multiple claims and billing tasks simultaneously while maintaining quality and accuracy" Note there are missing spaces; we need to preserve as is but we can format nicely. We can break into list items: - Thorough knowledge and understanding of medical billing, insurance and private pay. - Knowledge of all medical billing requirements for Medicare, Blue Cross, Medical Assistance, Commercial insurance, and HMO carriers - Strong collection skills, including claims follow-up, revenue cycle practices - Strong computer skills, including EMR knowledge and Microsoft Office. Excel preferred. - Strong interpersonal skills - Excellent verbal and written communication skills for interacting with patients, families, insurance companies and healthcare providers. - Strong ability to investigate issues, find solutions, and work under pressure to resolve billing issues. - Efficient in managing multiple tasks, prioritizing, and ensuring deadlines are met. - Ability to handle multiple claims and billing tasks simultaneously while maintaining quality and accuracy We should keep the exact phrasing; maybe combine some. - Pay: Pay Range $19.92 - $29.87 plus note: "Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs." We should not include EEO. Now produce HTML fragment. Structure:

  About the role

  Under direct supervision, performs all billing and collection functions on account balances within assigned financial classes. Ensures timely submission of all claims and timely follow up. Posts payments in EPIC. Perform eligibility, verification and authorization requests, as needed.

  All roles must demonstrate GBMC Values:

  • Respect: I will treat everyone with courtesy. I will foster a healing environment. Treats others with fairness, kindness, and respect for personal dignity and privacy. Listens and responds appropriately to others’ needs, feelings, and capabilities
  • Excellence: I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others. Meets and/or exceeds customer expectations. Actively pursues learning and self-development. Pays attention to detail; follows through
  • Accountability: I will be professional in the way I act, look and speak. I will take ownership to solve problems. Sets a positive, professional example for others. Takes ownership of problems and does what is needed to solve them. Appropriately plans and utilizes required resources for various job duties. Reports to work regularly and on time
  • Teamwork: I will be engaged and collaborative. I will keep people informed. Works cooperatively and collaboratively with others for the success of the team. Addresses and resolves conflict in a positive way. Seeks out the ideas of others to reach the best solutions. Acknowledges and celebrates the contribution of others
  • Ethical Behavior: I will always act with honesty and integrity. I will protect the patient. Demonstrates honesty, integrity and good judgment. Respects