Billing Specialist Ii

Description

This position is responsible for the billing and collection functions (a/k/a claims filing) of the institutional and professional services rendered by the Hospital Authority of Miller County (HAMC) to its patients. The Biller will work under the direction of Patient Financial Services Leadership to carry out duties pertaining to the claim’s life-cycle.

• Performs all job responsibilities in alignment with the mission and vision of the organization.
• Performs other duties as required and completes all job functions as per departmental policies and procedures.
• Maintains current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
• Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
• Wears protective clothing and equipment as appropriate.

• Ability to communicate in English, both verbally and in writing.
• Additional languages preferred.
• Strong written and verbal skills.
• Basic Computer Skills

• General environment:
  Works in a well-lighted, air-conditioned area, with moderate noise levels.
• May be exposed to high noise levels and bright lights.
• May be exposed to limited hazardous substances or body fluids, or infectious organisms.
• May be required to change from one task to another or different nature without loss of efficiency or composure.
• Periods of high stress and fluctuating workloads may occur.
• May be scheduled as needed including overtime.

• Have near normal hearing:
  Hear alarms/telephone/normal speaking voice.
• Have near normal vision:
  Clarity of vision (both near and far), ability to distinguish colors.
• Have good manual dexterity.
• Have good eye-hand foot coordination.
• Ability to perform repetitive tasks/motion.
• Continuously within shift (67-100%):
  Standing, Walking.
• Frequently within shift (34-66%):
  Bending/Stooping, Pushing/Pulling, Lift/carry up to 20lbs, Lift/carry greater than 20 lbs. with assistance.
• Occasionally within shift (1-33%):
  Sitting, Climbing, Twist at waist, Lift/Carry greater than 50 lbs. with assistance, Reaching above shoulder.

QUALITY HEALTHCARE:
In our continuing effort to enhance the quality of life for the communities we serve, the Hospital Authority of Miller County is committed to the delivery of superior, safe, cost-effective healthcare through the provisions of education prevention, diagnosis and treatment.

• Prepare, review and transmit 837 inpatient and outpatient claims using the billing software for electronic and paper claim submission
• Follow-up on unpaid claims aged over 30+ days, notating status in the billing software
• Coordinate with the Patient Access Representatives to verify and understand the patient’s benefits and eligibility
• Process account payments, adjustments, reconciliations, and refunds within the timeframe set by the insurance company
• Participate in required departmental training which may include training provided by Relias, Home Town Health, Georgia Hospital Association, Medicaid, Medicare and various other trade organizations
• Demonstrate problem-solving skills in the areas of denials, appeals, and collections
• Demonstrate knowledge of Medicaid, Medicare, HMOs, PPOs, CMOs and other payer’s requirements
• Demonstrate proper understanding of Electronic Health Record and Billing software systems, Microsoft Office Suites and other office equipment
• Demonstrate ability to write appeals for denied claims at Level 1
• Must possess critical thinking and problem-solving skills
• Demonstrate the ability to thrive in a fast-paced work environment while giving excellent attention to detail
• Complete special Revenue Cycle Management projects as required or assigned
• Other responsibilities as assigned

• Follows Code of Conduct policy.
• Adheres to dress code; appearance is neat and clean.
• Completes annual educational requirements.
• Maintains regulatory requirements.
• Maintains patient confidentiality at all times.
• Reports to work on time and as scheduled; completes work within designated time.
• Wears identification when on duty; uses computerized…