Billing Specialist

Patient Account Processing

Responsible for the timely processing of duties and/or activities related to the accurate processing and handling of patient accounts. Ensures that all patient account information, charges, billings, and follow-up activities are accurate, complete, and timely.

Essential Functions

• Reviews patient account information for completeness and accuracy.
• Makes necessary changes/updates to patient account information to ensure timely payment on accounts. Retrieves status information from government and third party payers regarding outstanding professional claims.
• Coordinates with governmental agencies, third-party payers, and internal auditors to ensure maximum reimbursement for hospital services.
• Acts as a liaison between the hospital and third party payers in resolving billing and reimbursement issues.
• Provides follow-up on claim edits, rejections, denials, and outstanding professional claims in a timely manner.
• Maintains patient records and ensures confidentiality of sensitive information.

Education Requirement

• High school diploma, required.
• Associates degree, preferred.

Licensure Requirement

(not specified)

Certifications

(not specified)

Skills

• Knowledge of medical terminology, various claim forms, third party contracts and payment patterns, CPT and ICD9 coding, and reimbursement regulations and policies of third party payers.
• The ability to do data entry and work a calculator.
• Problem identification and problem solving skills, required.
• Excellent interpersonal, verbal, and written communication skills.
• Excellent organization skills and the ability to comprehend and follow written and verbal instructions.

Experience

• Two years' experience in medical billing, claims follow-up and customer service, required.
• One year experience working on a mainframe computer. Experience using Outlook, Word and Excel, required.

Physical Requirements

OCCASIONALLY: Lifting / Carrying: 0-10 lbs, Lifting / Carrying: 11-20 lbs, Pushing / Pulling: 0-25 lbs, Reaching above shoulder, Squat/kneel, Standing, Walking

FREQUENTLY: Flexing/extending of neck, Patient Equipment, Peripheral vision

CONTINUOUSLY: Audible speech, Color vision, Computer skills, Decision Making, Depth perception, Hand use: grasping, gripping, turning, Hearing acuity, Interpreting Data, Problem solving, Repetitive hand/arm use, Seeing Far/near, Sitting

Additional Physical Requirements Performed But Not Listed Above

(not specified)