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Billing Specialist

Plano, Texas | Contract To Hire

Post Date: 06/06/2017 Job ID: 4313 Industry: Healthcare

Job Purpose

The Billing Specialist provides billing services for the organization. Within this position there are essential functions that may apply on one Billing Specialist, but not to another.   This position may be responsible for posting charges and declines, re-submissions, adjustments, payments, managing accounts, coding, process Explanation of Benefits (EOB), appeals, negotiating settlement payments, and investigates rejected claims. In addition, the Billing Specialist can be cross-trained in other functions of the Billing Department such as: posting, processing patient statements, answering and resolving billing inquires, process appeals and appeal correspondence.

Essential Functions

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
  • Reconcile bills and codes to ensure they are free from discrepancies
  • Enters claims, updates, post, reconcile and apply insurance and patient payments
  • Identify and enter correct patient diagnosis and CPT codes
  • Investigates rejected claims and ensures claims are billed and coded correctly.
  • Identify, correct, and submit billable claims
  • Process exclusion and end of day reports daily
  • Create spreadsheets in billing software to organize, update and maintain patient accounts.
  • Manage the pending accounts for billing
  • Follow-up on insurance and patient aging reports
  • Research and resolve patient billing inquires, incorrect payments, EOB rejections, and outstanding accounts
  • Investigate unidentified cash and resolve misapplied payments.
  • Retrieve Electronic Remittance Advice
  • Reconcile and post insurance and patient payments
  • Verify secondary insurance and post accordingly
  • Process charge corrections, reconcilations, and monthly patient statements
  • Provide mentoring and training as required
  • Answers patient and facility calls professionally and pleasantly
  • Regular and timely attendance
  • Maintains strictest confidentiality and adheres to all HIPAA guidelines and regulations

PERFORMANCE FACTORS
  • Dependability:  The employee can be depended upon to complete work in a timely, accurate, and thorough manner and is conscientious about assignments.  Being dependable also includes promptness, regular attendance and compliance with work/departmental policies, procedures and protocols.

 
  • Communication & Contact:  The employee communicates effectively both verbally and in writing with superiors, peers, and individuals inside and outside the Company.
  •  
  • Relationship with Others & Attitude:  The employee works effectively and relates well with others including superiors, peers, and individuals inside and outside the Company.  The employee exhibits a professional manner in dealing with others and works, to maintain constructive working relationships.

 
  • Self-Motivation & Initiative:  The employee asks questions concerning projects and assigned tasks.  The employees volunteers to take on addition responsibilities to meet the needs of the department.

 

Knowledge, Skills and Abilities
  • Excellent written and verbal communication skills
  • Ability to relate and communicate with all levels of management.
  • Ability to maintain a high degree of professionalism and integrity.
  • Possess strong and effective customer service skills.
  • Display excellent judgement at all time
  • Consistent attention to detail and follow-up
  • Must be a team player, be flexible, and be a good listener with a high level of patience.
  • Ability to manage sensitive, confidential issues
  • Ability to work in a fast-paced deadline oriented environment
  • Ability to multi-task, prioritize workload
  • Strong organizational and time management skills

 

SUPERVISORY RESPONSIBILITY

This position has no supervisory responsibilities

 

Education & Work Experience
  • High School diploma or GED equivalent
  • One to 3 years of medical billing experience
  • Basic Microsoft Office and medical billing software experience.

 

PREFERRED EDUCATION AND EXPERIENCE
  • Post high school education

 

Work Environment

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

 

physical Requirements

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.

 

While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands to finger, handle or feel; lift up to 25 lbs.; and reach with hands and arms.

 

POSITION TYPE/EXPECTED HOURS OF WORK

This is a full-time hourly position. Days and hours of work are Monday through Friday, 8: 00 a.m. to 5: 00 p.m. with possible overtime to include weekdays and/or weekends as business needs demand.

TRAVEL

No travel is expected for this position.

OTHER DUTIES

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.

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