Lead Billing Specialist

Job Description

Job Description

Position Overview:

This position is responsible for handling day-to-day technical billing questions from team, training/re-training staff and/or new hires, reviewing demographics, running eligibilities, preparing and submitting claims to appropriate insurances, corresponding with patients, reviewing and analyzing accounts receivable balances, and other duties as assigned to support the Billing Department. 

Essential Function:

Handle day-to-day technical questions from billing team/billing department.

Assist with training and/or re-training of staff or new hires.

Communicate departmental updates, regulatory updates, procedural updates, etc. to billing team/billing department.

Communicate with direct supervisors and department leadership on a routine basis.

Verify insurance eligibility and coverage for patients and maintain pre-authorizations, as needed

Document all correspondence with insurance carriers, patients, and other resources associated with the patient’s financial account

Prepare and submit claims to patients and insurance companies ensuring accuracy and completeness

Review, analyze, and follow up on unpaid claims to collect accounts receivable

Review documentation in the patient’s medical record to identify diagnosis, procedures, and other necessary information to complete billing the encounter. 

Field patient phone calls, take patient payments, set up payment plans, review and research patient accounts for purposes of identifying billing trends and maintaining a clean AR aging.

Educate and assist patients with the completion and submission of sliding fee discount program (SFDP) applications.  Review and recommend for approval SFDP applications.  Assist with SFDP renewal applications.

Must be able to accurately identify and populate account demographics.

Must be able to enter basic formulas and calculation in Excel for tracking purposes

Location and Hours of Position

PHN Billing Department: 118 Vine Avenue, Sharon, PA 16146.

The general office hours for this position are Monday - Friday 8:30am - 5:00pm.

Compensation

Position starts at $16.00 per hour, however, PHN recognizes certification, licensure, experience, education and site location when determining wage.

Qualifications:

High school diploma or equivalent.

1 to 3 years experience in a related billing or clerical position.

Knowledge of basic patient accounting and medical billing principles

Data entry in a high-volume work environment.

Detailed oriented.

Skill in establishing and maintaining effective communication skills and working relationships with other employees, patients, organizations, and the community

Benefits

Choosing PHN means more than a job title; it's a holistic experience that nurtures every facet of your well-being and aspirations.

• Medical/Dental/Vision (Employee and Family plans available immediately upon start date!)
• Employer Paid Short Term disability
• Employer Paid Life Insurance
• Retirement Plan
• Paid Time Off
• 8 Paid Holidays
• College Savings Plan
• Fitness Center Membership Reimbursement
• ID Shield & Legal Shield
• Volunteer Time Off Program

The Network

The Primary Health Network is the largest Federally Qualified Healthcare Center (FQHC) in the state of Pennsylvania. The mission of Primary Health Network is to enhance the health and well-being of the communities we serve by fostering trust and ensuring that every individual has access to high-quality, compassionate and exceptional healthcare.

With the Joint Commission Accreditation, we adhere to the highest standards of safety and quality in healthcare, ensuring top-notch services that surpass industry benchmarks. Some additional achievements that exemplify our commitment to optimal health and wellness include:

Patient Centered Medical Home Accreditation

Age Friendly Care Health System Participant

HRSA Community Health Quality Recognitions in COVID-19 data reporting, advancing health information technology for quality, and continued implementation of the Primary Care Medical Home care model.

Ranked an impressive #5 in the Government & Non-Profit sector by Inspiring Workplaces of North America for 2023

Accessibility Support for Applicants

Primary Health Network is committed to providing equal access to employment opportunities.

If you experience difficulty accessing our careers site or completing an application, or if you require a reasonable accommodation due to a disability, please contact us at View email address on ziprecruiter.com -health.net. Our team will work with you to provide an accessible alternative application process.

Primary Health Network is an Equal Opportunity Employer (EOE)