BILLING SPECIALIST

JOB TITLE: Billing Specialist

DEPARTMENT: Billing

REPORTS TO: Director of Revenue Cycle and Managed Care Services

FLSA STATUS: Nonexempt

POSITION SUMMARY

The Billing Specialist is responsible for pursuing and receiving all monies due from insurance companies and patients. The incumbent is also responsible for corresponding with CCHS' third-party billing company and managing accounts receivable for various payers and service areas.

KEY RESPONSIBILITIES

• Enters patient demographics, verifies insurance and reviews accounts for accuracy.
• Collects, posts, and manages account payments from insurance companies, public grant funded programs/service agreements and patients.
• Corresponds with third-party billing company to ensure timely follow-up of requested information (i.e. returns, refunds, recoupments, submission of hospital encounters, patient complaints, coding and fee inquiries, etc.)
• Manages accounts receivable for assigned service areas and payers.
• Develops payment plans as needed.
• Assists with fee schedule management as directed.
• Corresponds with Site Managers, providers and pharmacy staff regarding billing errors, information requests, returns, questions, etc.
• Monitors work queues to ensure all encounters are billed correctly.
• Handles mail and distributes accordingly.
• Communicates as needed with insurance companies.
• Assists with entry of NDC numbers as assigned.
• Assists with review of denial data and identifies training needs of providers, clinical staff and front office staff.
• Works with Accounting Department as necessary.
• Performs other duties as assigned.

POSITION REQUIREMENTS

Education: High school diploma plus some specialized training.

Experience: Four to six years of related experience; preferably back end revenue cycle

Licenses or Certifications: None required

Mental Requirements

Level 1 - Requires some concentration and normal attention. Generally, once the job is learned, the tasks can be performed more or less automatically.

Level 2 - Requires high periods of concentration intermittently and normal attention. Generally, even once the job is learned, tasks will require normal attention to deal with recurring variables.

Level 3 - Requires a high level of concentration and high level of attention intermittently. Generally, the approach to tasks may be consistent, but the number of steps required and/or the number of variables involved creates the possibility of errors unless the incumbent pays close attention.

Physical Requirements

Activity

Approximate % of Time

Comments

Sitting

95%

Standing

2%

Walking

3%

100%

Approximate percentage of time spent lifting, pulling and/or pushing: N/A

Maximum number of pounds required (with or without assistance): N/A

Types of objects the incumbent is required to lift/pull/push. N/A

Machines and Equipment Used:

Machines, Equipment, Tools

Approximate % of Time

Degree of Hand:Eye Coordination Required

• Computer

High

• Telephone

Normal

• FAX machine

Normal

Approximate percentage of time incumbent spends in "on-the-job" travel, excluding commuting to regular work location: N/A

Working Conditions

Typical office environment