Billing/Follow-up Specialist - Commercial Billing

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

1. Resolve insurance claim rejections/denials, and non-payment of claims by payors.
2. 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.
3. Responsible for drafting effective appeals to insurance companies for reimbursement of monies owed.
4. Responsible for maintaining daily account, follow-up work lists within department while maintaining organization’s productivity standards.
5. Ensure compliancy is met and process claims in accordance with contracts and policies, as well as to adjudicate claims as appropriate.
6. Responsible for identifying, researching, and resolving: credit balances, missing payments and unposted cash as it pertains to billing account follow-up.
7. 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.
8. Responsible for handling patient disputes and submission of issues to coding for review to ensure organizational and revenue cycle processes are followed.
9. Communicate appropriately with insurance companies, patients, co-workers and supervisors.
10. 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.