BILLING SPECIALIST

Job Description

Job Description

JOB TITLE: Billing Specialist

DEPARTMENT: Billing

REPORTS TO: Director of Revenue Cycle and Managed Care Services

FLSA STATUS: Nonexempt

POSITION SUMMARY

The Billing Specialist is responsible for pursuing and receiving all monies due from insurance companies and patients. The incumbent is also responsible for corresponding with CCHS’ third-party billing company and managing accounts receivable for various payers and service areas.

KEY RESPONSIBILITIES

1. Enters patient demographics, verifies insurance and reviews accounts for accuracy.
2. Collects, posts, and manages account payments from insurance companies, public grant funded programs/service agreements and patients.
3. Corresponds with third-party billing company to ensure timely follow-up of requested information (i.e. returns, refunds, recoupments, submission of hospital encounters, patient complaints, coding and fee inquiries, etc.)
4. Manages accounts receivable for assigned service areas and payers.
5. Develops payment plans as needed.
6. Assists with fee schedule management as directed.
7. Corresponds with Site Managers, providers and pharmacy staff regarding billing errors, information requests, returns, questions, etc.
8. Monitors work queues to ensure all encounters are billed correctly.
9. Handles mail and distributes accordingly.
10. Communicates as needed with insurance companies.
11. Assists with entry of NDC numbers as assigned.
12. Assists with review of denial data and identifies training needs of providers, clinical staff and front office staff.
13. Works with Accounting Department as necessary.
14. Performs other duties as assigned.

POSITION REQUIREMENTS

Education : High school diploma plus some specialized training.

Experience : Four to six years of related experience; preferably back end revenue cycle

Licenses or Certifications : None required

Mental Requirements

Level 1 – Requires some concentration and normal attention. Generally, once the job is learned, the tasks can be performed more or less automatically.

Level 2 – Requires high periods of concentration intermittently and normal attention. Generally, even once the job is learned, tasks will require normal attention to deal with recurring variables.

Level 3 – Requires a high level of concentration and high level of attention intermittently. Generally, the approach to tasks may be consistent, but the number of steps required and/or the number of variables involved creates the possibility of errors unless the incumbent pays close attention.

Physical Requirements

Activity

Approximate % of Time

Comments

Sitting

95%

Standing

2%

Walking

3%

100%

Approximate percentage of time spent lifting, pulling and/or pushing: N/A

Maximum number of pounds required (with or without assistance): N/A

Types of objects the incumbent is required to lift/pull/push. N/A

Machines and Equipment Used:

Machines, Equipment, Tools

Approximate % of Time

Degree of Hand:Eye Coordination Required

1. Computer

High

1. Telephone

Normal

1. FAX machine

Normal

Approximate percentage of time incumbent spends in “on-the-job” travel , excluding commuting to regular work location: N/A

Working Conditions

Typical office environment