Billing Specialist

Billing Specialist I - Full Time.

Purpose:

The Billing Specialist I is responsible for collecting and entering claims, posting insurance, submitting claims, and answering patient inquiries on accounts.

• Enters information necessary for insurance claims such as patient, insurance, and insurance  claim information in complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
• Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
• Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
• Work with patient to establish payment plan for past due accounts in accordance with provider policies, as needed.
• Follows HIPAA guidelines in handling patient information.
• Provides necessary information as needed to collection agencies for delinquent or past due accounts.
• Post insurance and patient payments using medical claim billing software.
• May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• Prepares and submits secondary claims upon processing by primary insurer.
• Understand managed care authorizations and limits to coverage such as number of visits.
• Verify patient benefits eligibility and coverage as needed.

• High School diploma or GED required.
• Billing experience preferred.

• Position Type:
  Full Time
• Shift: Day

Salem Memorial District Hospital
35629 Highway 72
Salem, MO 65560
Phone: