Billing Specialist
2 months ago
**General Statement of the Job & Essential Functions**:
**GENERAL STATEMENT OF JOB**
***Under general supervision, this position ensures all billings and payments are collected for services provided. Reports to the Reimbursement Supervisor.
**ESSENTIAL JOB FUNCTIONS**
Processes all identified insurance requirement edits and rejects to retransmit with corrected insurance information through the electronic billing system; transmits all electronic claims directly to the insurance carriers, process re-bills submitted to the billing department; and processes electronic insurance daily.
Verifies that all electronic acknowledgements were received by the insurance carriers, verifies eligibility and authorizations; identifies and bill secondary or tertiary insurances; submits required paper billing to insurance carrier on a daily/weekly basis; follow-up with insurance companies regarding any discrepancies in payments and on unpaid claims within standard billing cycle timeframe; interprets Explanation of Benefits (EOBs); and verifies and ensures that all insurance payments are accurate and in compliance with contract discount.
Performs administrative support work such as word processing, creating spreadsheets, data entry and retrieval, and functions that may require interpretation, judgment and determining appropriate processes to be used. Reviews forms, data and other information to ensure accuracy and conformance to established procedures and policies.
Performs other related work as required. Individual assignments will be determined by supervisor based on current workload and department needs.
**Knowledge, Skills & Abilities**:
**PERFORMANCE INDICATORS**
***Knowledge of Job**:Has thorough knowledge of insurance billing such as practices to ensure accuracy and appropriateness of all transactions, to include compliance with policies and operational requirements. Has considerable knowledge of principles and processes for providing customer service, including setting and meeting quality standards for services and evaluating customer service. Has considerable knowledge of arithmetic, spelling, grammar, punctuation and vocabulary. Has considerable knowledge of the policies and procedures, organization and function of the department. Is skilled in the operation of common office equipment, including popular computer-drive word processing, spreadsheet and file maintenance programs. Is able to screen communications and, based on content, handle independently or route to proper source. Is able to correct spelling, grammatical, punctuation and typing errors. Is able to use independent judgment in organizing and establishing format. Is able to gather information from a variety of sources and draft documents. Is able to establish and maintain moderately complex files. Is able to communicate effectively orally and in writing. Is able to exercise tact and courtesy in frequent contact with the general public. Is able to establish and maintain effective working relationships as necessitated by work assignments.
**Quality of Work**:Maintains high standards of accuracy in exercising duties and responsibilities. Exercises immediate remedial action to correct any quality deficiencies that occur in areas of responsibility. Maintains high quality communication and interacts within department and division, and with co
- workers and the general public.
**Quantity of Work**:Maintains effective and efficient output of all duties and responsibilities as described under "Essential Job Functions."
**Dependability**:Assumes responsibility for doing assigned work and meeting deadlines. Completes assigned work
- on or before deadlines in accordance with directives, City policy, standards and prescribed procedures. Accepts accountability for meeting assigned responsibilities in the technical, human and conceptual areas.
**Attendance**:Attends work regularly and adheres to City policies and procedures regarding absences and tardiness. Provides adequate notice to higher management with respect to vacation time and time-off requests.
**Initiative and Enthusiasm**:Maintains an enthusiastic, self-reliant and self-starting approach to meet job responsibilities and accountability. Strives to anticipate work to be done and initiates proper and acceptable direction for completion of work with a minimum of supervision and instruction.
**Judgment**:Exercises analytical judgment in areas of responsibility. Identifies problems or situations as they occur and specifies decision objectives. Identifies or assists in identifying alternative solutions to problems or situations. Implements decisions in accordance with prescribed and effective policies and procedures and with a minimum of errors. Seeks expert or experienced advice and researches problems, situations and alternatives before exercising judgment.
**Cooperation**:Accepts supervisory instruction and direction and strives to meet the goals and objectives of same. Questions such instruction an
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