Patient Accounts Billing Specialist

The Patient Accounts Billing Specialist is responsible for the timely, accurate, and complete claim process and for entering and processing a variety of data into SMA Healthcare's computer systems. This position is responsible for understanding all processes associated with billing clean claims, correctly posting payments/adjustments and maintaining a clean AR. The Billing Specialist serves as a liaison between SMA HealthCare's clients and the organization. The Billing Specialist will be observing client accounts to identify overdue payments, report collection activity, address client inquiries and develop payment plans. Top reasons to work for SMA Healthcare: Career growth and advancement potential Great benefits such as: Health, Dental, Vision, Life, & Disability Insurance Tuition Reimbursement Paid Personal Leave and Paid Holidays 403b Retirement Plan (matches one to one of employee contribution for the first 3%, then a 50% match on the next 6% of employee contribution) *Billing experience required* Essential Job Functions: Performs eligibility verification andauthorizations, and verifies all areas of client account for correctinformation, to ensure clean claim is billed. Follows up with insurance company on unpaidor rejected claims, and resolves issues and re-submits claims. Enters information daily into EMR including documentingattempts for resolving payment or claims with issues. Follows through with Appeals utilizing thepayer specific process for timeliness. Timely completes all processes involving theMedicare Cost Report as directed. Obtains claims address and identification fornew insurance companies and notifies billing supervisor immediately ifany updates are necessary. Interacts with UR/Insurance Specialist staffto ensure the completion and/or correction of all billing paperwork forclean claim submission. Understands managed care authorizations andlimits to coverage such as the number of visits. Downloads payment reports utilizingappropriate portals, clearinghouse and EOB's. Processes specific adjustments and reasoncodes and balances after every EOB. Monitors all manual entry where paymentreports are unavailable. Balances day deposits and current clientpayments and reconciles daily for each. Identifies and corrects posting errors asthey occur. Answers patient inquires on account statusand charges, and answers patient questions on patient responsible portions,copays, deductibles, write-off's, etc. Resolves patient complaints or explains whycertain services are not covered. Works with patients to establish payment planfor past due accounts. Processes payments and refunds under thedirection of the Patient Account Manager. Prepare and present reports on collectionactivities and progress. Performs miscellaneous job-related duties asassigned. Qualification Requirements: To perform this jobsuccessfully, an individual must be able to perform each essential dutysatisfactorily. The requirements listed below are representative of theknowledge, skill, and/or ability required. Reasonable accommodations may bemade to enable individuals with disabilities to perform the essentialfunctions. Minimum Education and/or Experience: Possession of ahigh school diploma and experience in collection, accounts receivable, and/ordata entry required. Knowledge/Skills/and Abilities: Proven experience as a Collection Specialist or similar role. Knowledge of billing procedures and various collection techniques. Ability to communicate with clients and discuss overdue payments. Comfortable working with specific benchmarks and timelines. Knowledge of collection laws and regulations. Excellent communication and interpersonal skills. Ability to use various computer programs, including Microsoft Word,databases and Excel. Ability to prepare clear and concise reports. Ability to plan, organize and carry out work as assigned. Necessary Special Requirements: Possession of a valid Florida driver's license, acceptable drivingrecord, and proof of personal automobile insurance if required to drive anSMA vehicle and/or use a personal vehicle for SMA business. Complete State ofFlorida mandatory background screening prior to start of employment. Complete SMA required training during thefirst six (6) months of employment and updated if required. Physical: Mobility and ability to bend andreach during an 8-12 hour day. Able to lift minimum 10 pounds. Visual andauditory acuity sufficient to evaluate, intervene, treat, and record clienthealth care needs. Fine motor skills for legible and accurate charting, dailycorrespondence and presentation, either manually or orally. Work enduranceability to work 8-12 hour shifts with a meal break, as possible. Routine8-12hour shifts. Hours and days off may vary. Extra hours may berequired. Work assignment locations may vary. Application: This position description has been designed to indicate the generalnature and level of work performed by employees within this classification.It is not designed to contain or be interpreted as a comprehensive inventoryof all duties, responsibilities and qualifications which may be requiredofthe employee assigned to the position. It should not be used to limit thenature and extent of assignments such individuals may be given. #J-18808-Ljbffr