PFS-Billing Specialist FT/Day - Mee Memorial Hospital : Job Details

JOB SUMMARY: Executes actions which promote timely, accurate and effective billing, follow-up, cash posting, problem resolution and positive customer service. Ensures all necessary information and proper documentation are provided. Monitors delinquent accounts in order to receive overdue payments and return accounts to current payment status. Responds to customer inquiries regarding account status, resolves discrepancies and prepares adjustments as necessary.

PERFORMANCE DIMENSIONS AND TASKS

Essential Function

Billing Insurance Claims

1. Reconciles billing and invoices, checks balances, drafts statements, and maintains client files.

2. Reviews and verifies insurance accounts against program provisions. Analyzes and reviews claims to ensure that payer-specific billing requirements are met.

3. Ensures that timely filing guidelines are met with all payers

4. Resolves routine patient billing inquiries and problems.

5. Follows up on billing, applying appropriate adjustments as needed.

6. Works denials in a timely fashion

7. Documents all actions in billing system utilizing action codes

8. Submits corrected, adjusted, or rebilled claims to health plans

9. Ensures coding requirements are met through the clearing house

10. Collaborates with Patient Access, HIM, and other departments to ensure all information is collected and documented on each encounter.

11. Maintains strictest confidentially; adheres to all HIPAA guidelines and regulations

12. Other duties as assigned

QUALIFICATIONS

Education: High School Diploma or its equivalent - Required

Experience: Requires 3 years work experience or equivalent combination of knowledge, skill, or ability.

Performs work under general supervision. Handles moderately complex issues and problems, and refers more complex issues to higher-level staff. Possesses solid working knowledge of subject matter.

Skill Requirements: Written communication skills. Ability to identify and seek needed information/research skills. Analytical thinking skills. Detail oriented. Ability

to meet deadlines. Mathematical skills. Accounting skills.

Licensing Requirements: None

Language Requirements: Bilingual (English/Spanish) Preferred

Physical Demands: Requires full range of body motion including manual finger dexterity and hand-eye coordination

Special Demands: Willing to perform repetitive tasks.

Ability to work with others and to perform a variety of assigned tasks.

Excellent critical thinking skills

Strong analytical skills required.

DISCLAIMER: The preceding job description has been designed to indicate the general nature and level of work performed. It is not designed to contain or be interpreted as a comprehensive inventory of all duties, responsibilities and qualifications required of employees assigned to this job.