Professional Billing Specialist - Rev Cycl _Prof Billing_QHS Day Shift

RESPONSIBILITIES

I. JOB SUMMARY/RESPONSIBILITIES:

• Follows-up on payment with insurance payers and patients on outstanding accounts.

• Expedites larger dollar accounts to ensure prompt payment. Monitors to ensure all insurance balances are paid in a timely manner.

• Performs accurate and timely billing of patient accounts in accordance with policies and procedures of The Queen’s Health Systems (QHS) and in compliance with federal, state, insurance carriers, health plans and other third party payor requirements, as assigned.

• Ensures accurate claims submission to optimize revenue for the Medical Center, as assigned.

• Responds to patient and insurance inquiries promptly and courteously.

II. TYPICAL PHYSICAL DEMANDS:

• Essential: standing, sitting, walking, seeing, hearing, speaking, finger dexterity, repetitive arm/hand motions and gripping of an object.

• Operates various office equipment such as computer, copier, facsimile, telephone, typewriter, etc.

III. TYPICAL

WORKING CONDITIONS:

• Not substantially subjected to adverse environmental conditions.

• Some exposure to communicable diseases and other conditions common to a hospital and office environment.

IV.

MINIMUM QUALIFICATIONS:

A. EDUCATION/CERTIFICATION AND LICENSURE:

• High school diploma or equivalent education.

• Associate’s or Bachelor’s degree in business administration, finance, accounting or healthcare related field preferred.

B.

EXPERIENCE:

• One (1) year professional billing experience, preferably in a comparable organization. An Associate’s or Bachelor’s degree in business administration, finance, accounting or healthcare related field may be substituted for one (1) year experience in professional billing.

• Knowledge of Medicaid, Medicare, Third Party payer requirements, SNF/ICF, ICD-10 and DRG’s.

• Knowledge of medical terminology.

• Experience and/or background to demonstrate effective written and verbal communication skills in English.

• Experience with Windows applications, such as Word, Excel, etc., demonstrated proficiency in using mouse and keyboard.

• Experience with computer based applications, preferably in SMS and/or EPIC systems.

Equal Opportunity Employer/Disability/Vet