WorkHealth Department: Work Health - Administration
Position is located: Cianchette Professional Blding
Work Type: Full Time
Hours Per Week: 40.00
Work Schedule: Variable
Summary: The Billing Specialist is a key role responsible for coordination of all billing and payment posting functions of Northern Light Work Health, which consists of 8 statewide clinics and two additional cost centers. The incumbent is responsible for all aspects of the billing cycle including submission of worker's compensation claims and employer/client invoices, payment posting and denial resolutions, daily cash reconciliation and payment posting. The Billing Specialist monitors accounts receivable and manages client accounts independently with minimal supervision. Must be poised, professional and have excellent interpersonal skills to interact with individuals of all levels, both within and outside of our organization.
Responsibilities:
- Processes accurate claim and client invoice submission, daily or as needed
- Accurately applies payments and reconciles with cash logs, daily and month end.
- Processes denied claims, follows appropriate appeal process, and escalates as needed per payer guidelines.
- Investigates and resolves credits for appropriate refunds or adjustments.
- Participates in active AR recovery and maintains accounts receivables at acceptable level, meeting standards outlined in KPIs
- Maintains high level of knowledge/familiarity with worker's comp rules and regulations regarding billing, coding, and payment processing
- Other Duties
Other Information:
Competencies and Skills - Behaves with Integrity and Builds Trust: Acts consistently in line with the core values, commitments and rules of conduct. Leads by example and tells the truth. Does what they say they will, when and how they say they will, or communicates an alternate plan.
- Cultivates Respect: Treats others fairly, embraces and values differences, and contributes to a culture of diversity, inclusion, empowerment and cooperation.
- Demonstrates Adaptability: Learns quickly when facing a new problem or unfamiliar task; is flexible in their approach with changing priorities and ambiguity. Manages change effectively and does not give up during adversity. Capable of changing one's behavioral style and/or views in order to attain a goal. Absorbs new information readily and puts it into practice effectively.
- Demonstrates Emotional Intelligence: Exhibits a high level of self-awareness, self-management, other awareness and relationship management. Conducts themselves in an empathic, appropriate way, with a sense of humor and stimulates a collaborative work environment. Is respectful of the attitudes, feelings, or circumstances of others and aware of the influence of their own behavior on them. Is aware of relevant social, political, system, and professional trends and developments and uses this information for the organization's benefit.
- Effectively Communicates: Listens, speaks and writes appropriately, using clear language. Communication methods are fitting to the message(s), audience, and situation and follow-ups are regular and timely. Shows that important (non-) verbal information is absorbed and understood and asks further questions to clarify when necessary. Expresses ideas and views clearly to others and has ability to adjust use of language to the audiences' level.
- Fosters Accountability: Creates and participates in a work environment where people hold themselves and others accountable for processes, results and behaviors. Takes appropriate ownership not only of successes but also mistakes and works to correct them in a timely manner. Demonstrates understanding that we all work as a team and the quality and timeliness of work impacts everyone involved.
- Spreadsheet application with the ability to use calculations, formulas, graphing tools, pivot tables, and a macro programming.
- Word processing, spreadsheets, data entry, database experience and other computer related skills.
- Email application with the ability to manage email as well as calendars, managing tasks and contacts, note taking, journaling, and web browsing.
- Presentation software with the ability to create presentations with the ability to incorporate animation, audio, video, time delays, as well as designing themes and variants with animations and effects.
- MS Teams
- Word process application with the ability to create and edit documents, format, use tables, apply footnoting, create table of contents and mail merge techniques.
- Multi-line phone, scanner, photocopier, fax, and internet.
- Practices Compassion: Exhibits genuine care for people and is available and ready to help; displays a deep awareness of and strong willingness to relieve the suffering of others.
- Siemens Clinical software.
- Utilizes Resources Effectively: Understands how to get the most out of available resources and uses cost-benefit thinking in decision-making and in setting priorities. Monitors and analyzes resource usage to identify and eliminate areas of waste and maximize resources. As a leader, defines targets and provides appropriate means; oversees progress and makes adjustments when necessary. Appropriately delegates work, sets clear direction and manages workflow and time.
- Zoom
Education - Required Associate's Degree4 years of related experience in lieu of degree
Required Experience - 2 year/years of Relevant Work Experience
Working Conditions - Potential exposure to noise levels being uncomfortable.
- Extend body and limbs to reach items.
- Prolonged periods of kneeling.
- Prolonged periods of sitting.