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Billing and Collections Specialist I
2 months ago
JOB SUMMARY:
Under the supervision of the Manager of Professional Billing & Coding, the Billing & Collections Specialist I is tasked with reviewing and processing charges through our Electronic Medical Record (EMR) system. This role involves managing paper charge tickets received for services rendered at various locations. Utilizing relevant reports, the incumbent ensures that all anticipated charges are accurately received and recorded from healthcare providers.
This position requires verification of authorization for patient visits and procedures, ensuring that it is accurately reflected in the claim submission process. The specialist will also register new patients in the system, confirming patient demographics and verifying insurance eligibility and claim information for accuracy.
The incumbent is responsible for validating the appropriate use of Current Procedural Terminology (CPT) and International Classification of Diseases, 10th Revision (ICD-10) codes and modifiers for all charge sessions and encounters, employing specific warnings and edits to ensure correct charge routing to the billing system. They are expected to make necessary updates or corrections to guarantee precise reporting of services rendered.
The role includes daily processing of claim edits or rejected claims through the billing system and electronic claim vendor processing. The specialist must rectify all errors or warning flags to ensure clean claim submissions. Additionally, this position involves retrieving medical records to accompany claims and appeals as required by payors and validating claims associated with potential new payor plan coverage added to the patient's account.
SKILLS REQUIRED:
- Exceptional verbal communication and active listening skills.
- Strong emotional intelligence.
- Problem-solving abilities.
- Meticulous attention to detail.
- Technological proficiency.
MINIMUM QUALIFICATIONS:
- High School Diploma, GED, or equivalent.
- One year of relevant experience.
- Experience in medical billing.
- A certificate of completion from a medical billing course may substitute for one year of experience.
PREFERRED QUALIFICATIONS:
- Three years of relevant experience.
- Experience with EPIC is a plus.
COMPENSATION:
The expected hiring range for this position is $21.00 to $27.50. Rady Children's Hospital is dedicated to providing compensation that is both externally competitive and internally equitable. Regular market reviews are conducted to ensure competitiveness with similar organizations in the nonprofit healthcare sector. The range provided does not represent the full salary range for the position but reflects the expected hiring range for qualified candidates. Compensation decisions take into account various factors including experience, education, licensure, unique skill sets, organizational needs, and internal equity.
BENEFITS:
- Medical, dental, and vision insurance.
- Life insurance and pet insurance options.
- A retirement plan with company matching.
- A wellness program.
- Tuition assistance.
- Employee recognition awards and an annual event honoring all employees.
- Discounts on events and attractions.
- Various opportunities for community engagement and enjoyment.
