Billing Specialist - Medical/Dental/BH
- Posted: over a month ago
I. Position Function SUMMARY:
Under the general direction of the Billing Manager, the Billing Specialist is responsible for the timely completion of all billing functions including maintaining accurate record of all patient accounts, recording charges, payments, submitting reimbursement requests to all payers, following up on any denials, and provide backup eligibility services. The Billing Specialist works closely with the front office and providers on staff to insure accurate and timely information.
II. ESSENTIAL DUTIES AND RESPONSIBILITIES
This position may have various work assignments within HICHC. This description is intended to be generic in nature, and as such it does not detail all of the duties and responsibilities of a particular job assignment. It is not intended to determine specific duties and responsibilities of any particular position, and essential functions and overtime eligibility may vary based on the specific tasks assigned.
Ensure the timely input of patient billing data into the computer system with few errors.
- Maintain patient account information and up-date as necessary including new service and billing information, payments received, and patient demographic information.
- Ensure proper billing of patient charges to various payers.
- Prepare monthly and weekly reports as requested.
- Prepare outgoing patient billing statements according to the pre-established schedule.
- Maintain a record of all collections.
- Monitor accounts receivable and reprocess claims as necessary to maximize revenue.
- Counsel patients in setting up payment plans to recover outstanding balances.
- Request refunds to patients when there are overpayments.
- Recommend policies and procedure that will improve performance of the billing department and help maximize revenue collection.
- Update CPT and ICD-10 codes at least yearly as directed.
- Monitor HICHC fee schedules and recommend updates, when identified.
- Maintain insurance information on all providers and up-date when necessary.
- Provide back up to eligibility/verification position, as needed.
- Provide feedback to clinic operations staff and medical providers to ensure appropriate coding of encounters.
- Communicate and work closely with front office staff.
- Other duties as assigned.
III. POSITION QUALIFICATIONS
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and Experience
High School graduate or GED certificate and two years related experience and/or training in medical billing is required; OR any equivalent combination of experience, training and/or education.
Knowledge, Skills and Abilities
This position requires a basic knowledge of general office procedures to include filing, copying, and faxing.
- Ability to use a computer to enter patient data and retrieve information in a patient billing system.
- Knowledge of collections procedures, CPT and ICD-10 codes.
- Detail oriented with demonstrated organizational skills in creating and maintaining file system.
- Experience with basic bookkeeping.
- Ability to work on multiple tasks within established deadlines.
- Ability to work under the direction of a supervisor and follow instructions.
- Ability to read and interpret documents such as government regulations and guidelines, payer contracts, patient records, operating and maintenance instructions, procedure manuals, etc.
- Ability to write at a level of competence, including internal reports and memoranda.
- Ability to communicate with diverse groups of people to include staff and providers and patients.
- Ability to communicate effectively with patients and their families to make their visit a pleasant experience.
- Sensitivity to the multicultural nature of the service area population and may be required to communicate in another language.
Personal characteristics to include: a team player, high integrity, communication and customer relations skills, regular work attendance, courteous and friendly, able to work well with diverse groups of people, and gain and maintain respect of others.
Confidential and Sensitive Information:
Because the employee has access to personal and professional data regarding individual employees and their families, personal data regarding individual patients and the families, and/or sensitive company financial data, an essential job result is the maintenance of a high level of confidentiality of the information processed by the employee. Violation of this confidence may result in disciplinary action, including termination of employment.IV. PHYSICAL CHARACTERISTICS/WORKING CONDITIONS
General Remarks: The work environment described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform essential tasks and functions.
Environment: The noise level in the work environment is usually low to moderate. There are no known environmental hazards on the premises. Work environment is often stressful. Work is mostly inside, and normal office worker safety precautions and practices are required. Incumbent may be exposed to patients' conditions and some-unpleasant sights, smells and contagious diseases including virus, disease and infection from patients and specimens in working environment. All employees are offered the opportunity to receive the Hepatitis B vaccination series.
Equipment Use: Frequent use of telephone system and office equipment including but not limited to computer, printer, facsimile machine, copier and general office supplies. Occasional use of wheelchair, gurney and other assisted devices for patient transfers in the clinic.
Work Hours: Forty hour work weeks. Overtime may be required.
Mental Demands: Duties require attention to detail, alertness, problem solving, tolerance to stress and exercising sound judgment. Duties require high tolerance and adequate coping skills for dealing with loss, grief and bereavement. Good stress reduction and management skills are essential.
The foregoing position description is not all-inclusive of the duties that may be assigned to the employee. In order to ensure maximum flexibility and efficiency and to encourage cross training, employees will be assigned additional duties as deemed necessary or desirable by HICHC.
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