Patient Accounts - Billing Specialist

Job Summary

Process all billing claims via billing software or paper claims as needed. Follows up on all edits, denials to ensure all claims are coded and billed accurately in order for facility to receive reimbursement.

Duties And Responsibilities

• Prepare, submit, and manage medical claims using billing software such as TruBridge, including electronic, paper, and secondary claims.
• Verify insurance coverage and eligibility, ensuring accurate coding based on patient diagnoses and treatments.
• Maintain complete and accurate patient account information.
• Monitor claim status, investigate and appeal denied or rejected claims, resolve discrepancies, process refunds, and pursue collections on delinquent accounts to ensure timely reimbursement.
• Regular communication with patients, providers, and insurance payers is required, along with maintaining strict compliance with HIPAA, information security standards, and all state and federal billing and collections regulations.

Requirements

• Education: Requires high school diploma or equivalent.
• Experience: 4-6 years experience in medical collections required.

Skills

• Ability to coordinate and prioritize activities as related to insurance billing.
• Accurate, mature, flexible person who is meticulous to detail.
• Displays responsibility to confidentiality of medical information.
• Pleasant attitude in dealing with other departments as well as the public.
• Genuine concern for completeness and organization of routine office matters.
• Able to read and understand the explanation of benefits for all insurances.

Knowledge

• Ability to type 45 WPM, use a 10-key calculator, knowledge of medical terminology preferred.

Abilities

• Excellent grammar and communication skills.
• Self-starter.

Physical Requirements

• Sedentary Work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.
• Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• Use hands/fingers to handle or feel (Operate, Activate, Use, Prepare, Inspect, Place, Detect, Position)
• See (Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess)
• Talk/hear (Communicate, Detect, Converse with, Discern, Convey, Express oneself, Exchange information)
• Stoop, kneel, crouch, or crawl (Position self (to), Move)
• Walk (Move, Traverse)
• Stand or Sit (Stationary Position)
• Pushing or Pulling
• Repetitive Motion
• Reaching
• Taste/Smell (Detect, Distinguish, Determine)
• Exposure to Fumes
• Exposure to Dust
• Exposure to Noise

OSHA Categories

• Category III - Normal routine involves no exposure to blood, body fluid or tissue, and as part of their employment, incumbents are not called upon to perform or assist in emergency care or first aid

Physical Demands

• Sedentary Work - Exerting up to 10 pounds of force occasionally, and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body.
• Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
• Use hands/fingers to handle or feel (Operate, Activate, Use, Prepare, Inspect, Place, Detect, Position)
• See (Detect, Determine, Perceive, Identify, Recognize, Judge, Observe, Inspect, Estimate, Assess)
• Talk/hear (Communicate, Detect, Converse with, Discern, Convey, Express oneself, Exchange information)
• Stoop, kneel, crouch, or crawl (Position self (to), Move)
• Walk (Move, Traverse)
• Stand or Sit (Stationary Position)
• Pushing or Pulling
• Repetitive Motion
• Reaching
• Taste/Smell (Detect, Distinguish, Determine)
• Exposure to Fumes
• Exposure to Dust
• Exposure to Noise

Disaster Service Worker

All Lake Butler Hospital employees are designated “Disaster Service Workers” through state and federal laws. As Disaster Service Workers, all Lake Butler Hospital employees are expected to remain at work, or to report for work as soon as practicable following a significant emergency or disaster.