Billing Specialist

Job Description

Job Description

At Mahaska Health, the Billing Specialist is responsible for filing of clean claims to various insurance companies for all Hospital, Provider Based Clinic and Clinic services. The Billing Specialist will pursue collection of all claims until payment is made by insurance company. Biller will maintain current billing knowledge and changes of Medicare, Medicaid, and all third-party payers.

Open Hours:
Full-time: Monday - Friday 8:00 am - 4:30 pm

Essential job functions include but not limited to:

• Prepares and submits clean claims to various insurance companies either electronically or by paper.
• Verify all required information necessary to file all insurance claims and ensure that they are submitted timely and correctly.
• Work with providers or hospital departments to ensure correct charges, diagnosis and procedures are reported to insurance companies.
• Follow up on unpaid claims within standard billing cycle timeframe.
• Identifies and resolves patient billing complaints.
• Check insurance payments for accuracy and compliance with contract or discounts.
• Contact insurance companies regarding any discrepancy in payment.
• Identify and bill secondary or tertiary insurances.
• Handles all mail and correspondence appropriately and timely.
• Investigates claims involving third party and gathers all information necessary to file hospital lien in timely manner. Files satisfaction of lien.
• As needed, sends letters to patients to request additional information for payment of claims.
• Process late charges within standard timeframe.
• Primary point of contact regarding all billing for the office including insurance, 3rd party claims and other types of billing matters.
• Accurately process all claims, rejected and otherwise, on a daily basis to ensure maximum cash flow.
• Medicare Billing Specialist Only—accurately processes all RTP’s on FISS within the timely guidelines, keys Medicare secondary claims and adjustments thru FISS.
• Run, review and follow-up on reports to ensure accuracy for encounter forms, daily charge, daily receipts, insurance submissions and accounts receivables.
• Process refunds as needed.
• Maintains up to date billing requirements and changes for insurance types within their area of responsibility.

Job Requirements include but not limited to:

• High school diploma or GED equivalent required.
• PC proficiency, experience with IP and OP hospital insurance claims filing and reimbursement principles desired.
• Must be able to use and operate office equipment.
• Will be required to show proof of having completed Mandatory Reporter course at the time of hire or attend within 6 months of the start date.
• Must adhere to all training requirements as mandated by Federal, State, and Professional licensure and regulatory standards.