Patient Accounts - Billing Specialist - Full Time

Billing Specialist

Wilson Health is looking for a direct hire Billing Specialist for our Patient Accounting Department located in Sidney, Ohio (North Dayton, Ohio) area.

Key Perks and Benefits:

• Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.
• Medical Insurance: Choose from two High Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.
• HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.
• Company-paid Life Insurance and Long-Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance
• Industry-leading retirement plan employer contributions begin day one with no waiting period for participation.
• Tuition Assistance Program
• Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.
• Employees receive a 10% discount on food and beverages at the Wilson Cafeteria, Coffee Bar and Micro Mart

Employment Status: Full Time (FT=36+ hours) Working Hours: 40 hours a week (80 hours per pay period) - ONSITE for 6 months, Hybrid remote option available. Schedule: Monday - Friday (No Weekend or Holidays) Shift: 1st shift - FLEXIBLE hours between 6:30am - 5:30pm

Position Reports to: Director of Revenue Integrity

Department Description

Wilson Health's Patients' Account Department is responsible for handling the hospital billing and collection aspects of the patient's care during the service date (The date/date(s) when care was provided to the patient from the hospital or provider).

Job Summary

The Billing Specialist is responsible for releasing insurance claims electronically and mails hard copy UB/1500 claims as required. The Billing Specialist will also follow up on unpaid claims and rebill or appeal claims as indicated.

Essential Duties & Responsibilities

• Billing of claims through EPIC and Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits.
• Prior experience with Medicare facility billing experience required
• Submits claim electronically or hard copy for MSP claims with appropriate information from the primary payer.
• Bills secondary, tertiary, etc. claims electronically or mails the UB/1500 with EOB as required by Payer.
• Monitors claims using the Medicare and or Quadax online system
• Works closely with all departments throughout the hospital regarding charges and/or late charges.
• Responsible for the follow up of submitted claims to primary, secondary, and tertiary payers
• Works the 30 day and out worklist in EMR and contacts Payers via phone or Payer website regarding no pays.
• Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons. Biller or Collector will follow up on the Appeal.
• Works with Case Management and Medical Records regarding RAC audits, other audits, and inpatient denials.
• Works mail as it applies to the Biller or Collector to secure payment.
• Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal

Other Skills and Abilities

• Accurate typing skills, computer keyboard skills and data entry.
• Knowledge of medical terminology,
• CPT and HCPCS codes.
• Calculator skills.
• Ability to work in a highly stressful environment.
• Ability to adapt to change.
• Knowledge of Excel.
• Organization and prioritizing skills.
• Ability to communicate with co-workers.

Qualifications

• 1+ Year Previous hospital billing experience. Medical terminology and understanding of CPT and ICD 10 codes.
• EHR - Electronic Health Records (EPIC) required
• High school diploma or general education degree (GED)

Mission & Vision & Values

• Improve the health and wellness of the community by delivering compassionate, quality care.
• Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
• A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.

EOE (Equal Opportunity Employer)