Billing Specialist (GMG)

GENESIS HEALTHCARE SYSTEM

In order to fill our Mission of serving our community by helping each person achieve optimal health and well-being by providing compassionate, exceptional, and affordable healthcare services, all employees of Genesis HealthCare System must be committed to living the Genesis Mission and Genesis values of Compassion, Excellence, Integrity, Team, and Innovation. All employees must regard themselves as an 'owner' of Genesis and keep our patients at the center of everything we do - always.


Position Details:

Work Shift:
Day Shift (United States of America)

Scheduled Weekly Hours:
20

Department:
Physician Billing Dept

Overview of Position:

Bills accurate information to government and/or commercial payers according to established guidelines and government regulations. Serves as coordinator for GMG billing by performing and directing duties that process bills related to government payors according to governmental regulations. Coordinates and works with other departments, payors, attorneys, patients as appropriate and others as necessary to ensure correct information is billed. Responds to patient inquiries in a responsible, professional and caring manner for quality customer satisfaction.
ESSENTIAL DUTIES

1. Bills accurate information to government and commercial payers according to established guidelines and government regulations.
2. Works with payers as necessary to resolve problems resulting in correct and timely reimbursement.
3. Works rejections/denials and work lists in a timely manner to prevent write-off's.
4. Works with the coding and credentialing department to realize and correct denial patterns and to ensure optimum reimbursement.
5. Reconciles monthly banking logs with Accounting.
6. Reconciles daily office posting to Epic and shares information with appropriate practice managers.
7. Responds to patient inquiries and concerns in a responsible, professional and caring manner for quality customer satisfaction.
8. Demonstrates understanding of reimbursement systems including ICD& CPT required.
9. Plans & coordinates all activities regarding third party billing.
10. Ensures compliance with Medicare and other insurance carrier guidelines related to documentation.
11. Responsible for filing medical claims and follow up on pending and problem claims on a timely basis.
12. Communicates with patients and insurance companies as needed regarding insurance issues.
13. Ensures all electronic claims submissions and electronic reimbursement issues are addressed by working with venders and/or information systems.
14. Data entry of charges with verification of proper ICD and CPT codes - specific knowledge of coding applications.
15. Posts personal and insurance receipts.
16. Performs verification, pre-certification and referrals of scheduled surgeries.
17. Assists as collection coordinator, answer billing questions and set up payment arrangements.


QUALIFICATIONS

1. High school graduate or equivalent.
2. Minimum 2 years experience with PC's/computers.
3. Knowledge of medical terminology.
4. Experience using Excel and Word or equivalent applications.
5. Effective time management and organization skills.
6. Attention to detail, strong communication skills and effective listening.
7. Ability to concentrate with frequent interruptions.

PATIENT CENTERED CARE & BEHAVIORAL EXPECTATIONS

1. Living the Genesis Mission, Vision and Values:
• Performs work in a manner that is quality focused.
• Treats patients, co-workers, visitors and volunteers with courtesy, compassion, empathy and respect.
• Results oriented and focused on achievement of objectives.
• Acknowledges and responds to the diversity of people and the situation.
• Encourages peers (others) to be owners of change.
• Always makes the effort to anticipate and exceed customer needs and expectations.
• Possesses the ability to engage others with patience and understanding.
• Acts in a manner that creates positive first and lasting impressions.
• Demonstrates the ability to own issues until they are resolved.
2. Patient Centered Care (patients/families, physicians, co-workers, all other internal/external customers)
• Introduces self and role...connects with everyone.
• Communicates effectively (i.e. advising others of actions, pertinent information, time durations, etc.) and asks for feedback.
• Asks for and anticipates needs and concerns of others.
• Maintains a positive work environment for staff and a healing environment for patients (i.e. safe, clean, quiet, etc.)
• Maintains the dignity and privacy of each person; manages confidential/sensitive information appropriately.
• Responds to requests in an appropriate and timely manner.
• Exits patient/customer encounters courteously, asking if there are additional needs that can be addressed.
3. Promotes Patient and Employee Safety
• Demonstrates safe Patient Handling (i.e. transfers, transport, care administration, nutrition, medication, etc.)
• Demonstrates safe Materials Handling (i.e. appropriate use and disposal of chemicals, infectious wastes, etc.)
• Demonstrates appropriate knowledge of Infectious Disease precautions and use of proper protective equipment
• Demonstrates Slips/Trips and Falls Awareness.
• Actively contributes to maintaining a safe, clean and quiet environment.

WORKING CONDITIONS/PHYSICAL REQUIREMENTS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. Work is performed in an office environment.
2. Work may be stressful at times due to a busy office.
3. Interaction with others is constant and interruptive.
4. While performing the duties of this job, the employee is regularly required to stand, walk, talk, hear, use hands and arms.
5. The employee must regularly lift and/or move up to 10 pounds, and occasionally lift and/or move up to 25 pounds

This description reflects in general terms the type and level of work performed. It is not intended to be all-inclusive, nor portray the specific duties of any one incumbent.

Thank you for your interest in employment at Genesis. Genesis is committed to being an equal opportunity employer. Selection of applicants for employment is based only on qualifications and the requirements of a specific job.