Billing Specialist, Revenue Cycle, FT, 8A-4:30P

Description: Responsible for working/editing daily download of assigned Managed Care/HOM claims, optimizing the timely transmittal of accurate and clean claims daily. Billing Specialist I is responsible for identifying and obtaining invalid/missing claim data by communicating with other departments to secure and/or correct the data which prevents claim transmission. Protects payer filing deadlines by utilizing all available resources to resolve held claims, assures all known regulatory, contractual, compliance, and BHSF guidelines are adhered to. Must be willing to take on additional queues as backup to billing all carriers. Utilizes available system resources to resolve claim issues when appropriate, reports any billing system issues to Billing management, and assists other Billing Specialists with claim resolution or other projects as assigned. Estimated pay range for this position is $16.04 - $19.41 / hour depending on experience. Qualifications: High School, Cert, GED, Trn, Exper. AA preferred or equivalent. Managed Care/HMO contract billing experience required. 3-5 years prior experience in Billing of claims. Understanding of all required fields on a 1500 and/or UB for hospitals and diagnostic facilities is required. Background in coding or coding certification (CPC, CPC-H, CCS, or RMC) a plus. Experience in related business office functions including Federal Programs such as collections, refunds, review and adjudication of claims a plus. Knowledge and understanding of medical terminology, Correct Coding Initiative, Revenue Codes, DRG Guidelines, ICD‑9/10, CPT‑4, Modifiers & HCPCS codes, HIPAA regulations, statutory regulations, online verifications (DDE); internet savvy; knowledge of Microsoft Suite a must. Extensive analytical, critical thinking, detail oriented, problem solver, good mathematical, writing, and interpersonal skills required. Must be able to communicate effectively with other departments. In order to resolve pending/missing information on claims to expedite the timely transmission to payers. Excellent time‑management skills. Ability to multi‑task and work under pressure to meet stringent deadlines. Minimum required experience: 3 years. EOE, including disability/vets #J-18808-Ljbffr Baptist Health