BILLING SPECIALIST I

Job Description

Job Description

Under the supervision of the Billing Manager, the Billing Specialist I is responsible for scrubbing daily visits, posting charges, completing daily billing batches, responding to patient billing inquiries, and maintaining effective communication regarding billing-related matters with clinic staff, the Billing Manager, and clinic management.

Examples of Essential Duties and Responsibilities (not intended to be an exhaustive list of all responsibilities, duties, and requirements of the job):

• Maintains exemplary customer service skills with patients, vendors and co-workers.
• Complete patient check-out following clinical visits.
• Collect and post copayments, coinsurance, deductibles, and self-pay balances.
• Review charges, appropriate diagnosis and verify services rendered prior to billing.
• Checks patients’ eligibility for a variety of programs.
• Confirm and update patient demographics and insurance information.
• Generate patient statements, receipts, and follow-up instructions.
• Educate patients on billing questions, balances, and payment options.
• Apply payments and adjustments accurately in the practice management system.
• Identify and escalate billing discrepancies or missing documentation.
• Coordinate with clinical and billing teams to ensure clean claim submission.
• Maintains balanced day sheets and receipts; reviews and submits clinic batches in a timely manner so that billing can be sent out on a regular basis.
• Interacts daily with medical or support staff to ensure proper education and updates are given to assist billing in clean claim submission.
• Proofs and corrects claims prior to submission.
• Processes insurance authorizations as needed.
• May assist in training other employees on billing-related duties.
• Performs other reasonably related duties as assigned.
• Maintain compliance with HIPAA and organizational policies.

Other duties and responsibilities :

• Demonstrates understanding of and observe all SBNC policies, procedures, rules and regulations.
• Demonstrates successful work-related behaviors.
• Attend all required SBNC meetings and trainings.
• Interacts with patients, physicians, staff, vendors, and visitors in a positive manner that reflects the SBNC mission and philosophy.
• Keeps work area clean and orderly.

Typical Working Conditions:

Work is performed in an office or clinic environment. Occasional exposure to communicable diseases and other conditions in a clinic environment. Involves frequent contact with staff, patients, and the public. Contact may involve dealing with angry or upset people.

Qualifications:

Education:

High school diploma or equivalent. Medical coding training or equivalent.

Experience:

One year of medical front desk or medical billing experience is preferred. An equivalent combination of education and experience that provides the required knowledge and abilities will be considered.

Certification/ License:

None required.

Knowledge of:

• Medical terminology.
• CPT and ICD-10 coding.
• Use of standard software such as Windows, Word, and Excel.

Ability to:

• Speak English and Spanish fluently.
• Learn billing requirements of all SBNC payers and acquire an understanding of the electronic billing process.
• Follow verbal and written instructions.
• Communicate effectively, verbally and in writing.
• Use standard office equipment, including computers, copy machine, fax machine, and postage meter.

Physical Demands:

May be required to lift objects weighing up to 25 pounds. Sitting in a normal seated position for extended periods of time. Reaching by extending hand(s) or arm(s) in any direction. Finger dexterity required to manipulate objects with fingers rather than with whole hand(s) or arm(s), for example, using a keyboard. Communication skills using the spoken word. Ability to see within normal parameters. Ability to hear within normal range. Ability to move about. (These physical demands 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 of this job unless providing such accommodations would result in undue hardship for SBNC.)

Salary Range: $23.00 - $25.00 per hour