Job Description
Description
PeaceHealth is seeking a Billing/Follow-up Specialist - Commercial Billing for a Full Time, Day position. Hourly compensation starts at $17.26, more depending on experience.
JOB SUMMARY
Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote financial health.This position ensures acceptable reimbursement and appropriate days in Accounts Receivables with timely account follow-up and resolution of outstanding charges owed by third party payors.Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization.
ESSENTIAL FUNCTIONS
- Resolve insurance claim rejections/denials, and non-payment of claims by payors.
- Identify trends in billing and follow-up, maintaining working knowledge of state and federal billing guidelines in order to identify ways in which our patients can expedite resolution of insurance accounts and identify delays in processing.
- Responsible for drafting effective appeals to insurance companies for reimbursement of monies owed.
- Responsible for maintaining daily account, follow-up work lists within department while maintaining organization’s productivity standards.
- Ensure compliancy is met and process claims in accordance with contracts and policies, as well as to adjudicate claims as appropriate.
- Responsible for identifying, researching, and resolving: credit balances, missing payments and unposted cash as it pertains to billing account follow-up.
- Process, and maintain, within expectation, all correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.
- Responsible for handling patient disputes and submission of issues to coding for review to ensure organizational and revenue cycle processes are followed.
- Communicate appropriately with insurance companies, patients, co-workers and supervisors.
- Perform other duties as assigned.
QUALIFICATIONS
EDUCATION:
- Associates Degree or Medical Billing Certificate preferred
EXPERIENCE/TRAINING:
- Minimum of two years’ experience in a billing or insurance account follow-up capacity is required; Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered
- Medical terminology experience required
- Knowledge of insurance processes and billing guidelines regulations required
- Coding knowledge preferred
- Epic experience, specifically Resolute Billing Module experience preferred
OTHER SKILLS:
- Proficient use of computers including Microsoft Office 2010 applications
- Skilled in 10-key by touch and keyboarding
- Ability to operate general office equipment
- Exceptional verbal and written communication skills
- Excellent attention to detail and ability to multi-task
- Ability to work with minimal supervision, independently, as well as in a collaborative team setting
- Strong organizational skills with the ability to prioritize and meet deadlines
- Knowledge of Commercial and/or Government Payors
- Ability to identify, research, and resolve credit balances, missing payments and unposted cash as it pertains to billing account follow-up
SHARED SERVICES PHYSICAL/COGNITIVE REQUIREMENTS:
- Work requires fairly light physical exertion from up to 65% of the time.
- Ability to lift objects weighing 30 lbs. or less.
- Work is performed under normal working conditions with adequate lighting and ventilation.
- Job duties frequently require intense concentration and attention to detail (up to 65% of work time).
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For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.