PURPOSE STATEMENT:
The Billing and Payment Specialist is responsible for the expedient and accurate billing for treatment services posting of payments received for a group of facilities.
This is an onsite full-time, Mon-Fri opportunity!
ESSENTIAL FUNCTIONS:
- Responsible for billing all patient claims in a timely manner.
- Review claims issues, make corrections as needed, and rebill. Utilize claims clearing house to review and correct claims and to resubmit electronically when available.
- Responsible for evaluating bill cycles and changing/updating when necessary.
- Responsible for printing daily billing reports - both electronic and paper claims. Monitor validation percent.
- Work daily claims rejection lists.
- Responsible for posting insurance and patient payments, contractuals, and all other adjustments.
- Review explanation of benefits to ascertain that claim processed and paid correctly. If processed incorrectly provide detail information to collector for follow up.
- Complete adjustment forms if any adjustments need to be made to an account and attach all supporting documentation.
- Prorate patient accounts and monitor that balance due is in the correct financial class.
- Maintain daily cash log noting any variances on a daily basis.
- Gathers and interprets data from system and understands appropriate course of action to take and initiates time-sensitive and strategic steps resulting in payment.
STANDARD EXPECTATIONS:
- Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
- Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
- Develops constructive and cooperative working relationships with others and maintains them over time.
- Encourages and builds mutual trust, respect and cooperation among team members.
- Maintains regular and predictable attendance.
EDUCATION/EXPERIENCE/SKILL REQUIREMENTS:
- High school diploma or equivalent.
- 5 years of job-related experience, healthcare experience preferred.
- Advanced computer skills including Microsoft Office; especially Word, Excel, and PowerPoint.
- Knowledge of office administration procedures with the ability to operate most standard office equipment.
- Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
- Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
- Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
- Self-motivated with strong organizational skills and superior attention to detail.
- Must be able to manage multiple tasks/projects simultaneously within inflexible time frames. Ability to adapt to frequent priority changes.
- Capable of working within established policies, procedures and practices prescribed by the organization.
- English sufficient to provide and receive instructions/directions.
LICENSES/DESIGNATIONS/CERTIFICATIONS:
We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual's characteristics protected by applicable state, federal and local laws.