Billing and Recovery Specialist

Position Summary

Billing Specialist, is responsible for billing professional and institutional claims to the insurance company, resolving billing discrepancies, and working edits within an EMR system.

• Status:
  Full-Time
• Shift: Days
• FTE /
  
  Hours:
  
  1.0 / 40
• Schedule:
  
  Mon - Fri: 8:00am - 4:30pm

Education:

High School Diploma or General Educational Development (GED) required.

Licensure: N/A

Certification: N/A

Experience:

2+ years of general office experience and billing experience required.

• Strong communication, including writing, speaking and active listening
• Great customer service skills, including interpersonal conversation, patience, and empathy
• Good problem-solving and critical thinking skills
• In-depth knowledge of industry best practices
• Must be able to multi-task with multiple interruptions in a fast-paced environment

• The Billing Specialist is primarily responsible for preparing and submitting patient insurance claims, tracking claim statuses and resolving any billing discrepancies by following up on claim edits and claim rules within the system. The position needs a customer-oriented individual with a meticulous eye for details.
• Evaluate information for processing according to office guidelines and procedures.
• Collaborating with third party institutions and other team members to resolve billing inconsistencies and errors.
• Enter assigned data into the information system in accordance with policy and procedure.
• Conduct routine accuracy checks of selected data to ensure completeness and accuracy of data.
• Effectively utilize time to provide efficient customer service.
• Collect, record and audit data to ensure timely and accurate processing of paperwork to maximize reimbursement and achieve improved customer satisfaction.
• Actively participate in achieving team goals, setting priorities, seizing opportunities before being asked, and motivating oneself and others in order to maximize productivity.
• Maintain a high level of knowledge regarding government compliance regulations as well as third‑party billing requirements and regulations.
• Maintain up‑to‑date knowledge of all business office policies and procedures, team goals, department objectives and hospital strategic plans to maximize the decision‑making process.
• Demonstrate working knowledge of billing functions on the information system to continue to reduce receivables.
• Evaluate contractual postings to ensure proper billing to secondary payers.
• Maintain current knowledge of private, state, and federal contractual agreements, to ensure proper posting of payments and adjustments.
• Review and initiate correspondence with third party payers to resolve discrepancies.
• Identify, document and report billing system errors.
• Demonstrate communication and problem‑solving skills by clearly presenting information and options to customers while removing barriers that fail to enhance customer service.
• Contact third party and/or patients on unpaid account balances to reduce receivables. Resolve patient questions/complaints through written, verbal communication or through financial counseling.
• Maintain confidentiality to protect patient rights and privacy.
• Comply with safety activities, policies and procedures and regulatory requirements such as OSHA and The Joint Commission.
• Employee is responsible for all other duties as assigned for which competency has been demonstrated.

This position is classified as Sedentary Work, requiring the exertion of up to 10 pounds of force occasionally (up to 33% of the time) and/or a negligible amount of force frequently (33%-66% of the time) to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.