About the Position
Your Benefits
What Your Role Requires
JOB TITLE: INSURANCE BILLING SPECIALIST
REPORTS TO: Business Office Manager
I. JOB SUMMARY / OVERVIEW
? Interrelates with providers, insurance companies, other health care organizations, the
public, and staff in relation to insurance, credentialing, invoicing, accounts payable
accounts receivable, journal entries, and reconciliation.
II. PRIMARY DUTIES
Every effort has been made to include all duties; however, the omission of a specific
statement of duties does not exclude the duty from the position if the work is similar,
related or is a logical assignment of the position.
? Respond knowledgeably and courteously to inquiries from patients, providers, staff and
insurance companies.
? Process insurance claims on a daily basis. Work promptly and efficiently so claims are
paid timely.
? Post payments from insurance companies to proper patient accounts.
? Process refunds for insurance companies and patients as necessary.
? Follow up on, track, and investigate claim denials or claims not paid correctly for
current and aged receivables.
? Keep abreast of all changes and billable charges within individual insurance companies.
? Creates, tracks, and collects all invoices for medical records, OSHA, OCM, ect.
? Performs miscellaneous job-related duties as assigned.
III. EDUCATION / QUALIFICATIONS
? High school diploma or GED.
? Experience with medical insurance billing required
? Familiarity with ICD and CPT coding helpful.
? Knowledge of computer accounting programs, spreadsheets and applications.
? Knowledge of accounts receivable, basic accounting, and management principles.
IV. EXPERIENCE / KNOWLEDGE / SKILLS
? Knowledge of medical terminology, coding, and office procedures.
? Knowledge of third party and insurance procedures, regulations, and billing
requirements.
? Ability to identify, solve problems and correct errors.
? Ability to interpret billing and claims reports.
? Ability to function independently in prioritizing and organizing daily work.
? Demonstrate attention to detail.
? Ability to speak, read, write and comprehend instructions in English.
V. PHYSICAL DEMANDS
The physical demands described here are representative of those that must be met by an
employee to successfully perform the essential functions of this job. Reasonable
Insurance Billing Specialist 1accommodations may be made to enable individuals with disabilities to perform the
essential functions.
? While performing the duties of this job, the employee is regularly required to sit, use
hand and fingers, handle and feel objects, reach with hands and arms, talk and hear.
VI. MISCELLANEOUS
? Accepts and is supportive of change.
? Accepts guidance and suggestions for improvement.
? Willing to assist and work with others.
? Maintain strict and total personnel and patient confidentiality.
? Attend all required in-service meetings and department meetings.
? Complies with PrairieStar Health Center Policy & Procedure.
? Attend all required in-service sessions.
? Attend all required clinic meetings.