SUMMARY: Responsible for billing and collections for Medicare, Medicaid, Insurance, and Self Pay patients for all Medical and Dental clinics. Responsibilities of individual Billing Specialist will vary depending on assignment of responsibilities given by Billing Supervisor.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Provides billing information by collecting, analyzing, and summarizing third-party billings, accounts pending, and late charges data and trends. Updates job knowledge by participating in educational opportunities;
• Posting of all cash receipts and insurance payments to EHS software.
• Research and follow up on all denials for payment.
• Complete all 2nd Insurance filings.
• Review charges from daily batches and maintain monthly Deposit Journal, as needed.
• Assist Finance with reconciling EHS End of Day reports to Deposit Journal, as needed.
• Report received payments to Accounting Manager for all services to be reimbursed to Physicians.
• Cover vacancies at Patient Representative position during vacations, sickness, or vacant positions.
• Maintaining accurate ICD-9, CPT and HCPCS codes within the EHS software.
• Complete all required procedures on EHS software (i.e. End of Day, End of Month, etc.)
• Research all credit Accounts Receivable balances and perform required follow up to resolve credit balance.
• Research all Account Receivable balances and perform necessary follow up required to resolve Accounts Receivable balance issue.
• Assist in preparation of all Monthly/Quarterly/Annual reconciliations and other required reporting as required by governing agencies
• Assist Billing Manager in completion of all annual cost reports, annual financial audit, annual UDS report, and any other required annual governmental reporting.
• Other reasonable duties as required by the CEO, Billing Manager or the Board of Directors

QUALIFICATION REQUIREMENTS:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE:

High School diploma required. Associates Degree in Medical Billing and Coding preferred – or a combination of education and experience. Minimum of two years progressive billing experience required.

LANGUAGE SKILLS:

Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence.

MATHEMATICAL SKILLS:

Ability to apply basic concepts of mathematics and computations.

REASONING ABILITY:

Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.

COMPETENCY/SKILLS REQUIREMENTS:

Competency required in the areas of communication, excellent verbal and written skills. Use of computer skills to include Microsoft word and excel.

CERTIFICATES, LICENSES, REGISTRATIONS: None

OTHER SKILLS AND ABILITIES:

Familiarity with effective use of computerized accounting/billing systems. Must be able to use other equipment such as a fax, copier and calculator. Good organizational skills and the ability to perform numerous tasks simultaneously in a fast-paced office environment. Good analytical skills, sticker for details, sense of personal responsibility for work performance and a professional attitude. The ability to work without constant supervision and adhere to policies and procedures is a must.

PHYSICAL/MENTAL DEMANDS:

The physical/mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disability to perform the essential functions.

While performing the duties of this job, the employee is regularly required to talk or hear, sit, and use hands to finger, handle, or feel objects, tools, or controls. The employee is occasionally required to stand, walk, climb, balance on two feet, stoop, kneel, crouch, or reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.

Mental demands include the ability to learn, adapt to changes, pay close attention to details, exercise discretion and good judgment, develop options and solutions to crisis and problems, gather and analyze facts, courteous and professional behavior, deal with stressful situations and adhere to company policies and procedures.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

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