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Healthcare Billing Specialist
2 months ago
Position Overview:
The Healthcare Billing Specialist plays a crucial role in ensuring the efficient processing of all financial transactions related to patient accounts. This position is essential for securing timely reimbursement for services provided by the hospital.
The responsibilities include accurate billing of claims to patients and insurance providers, diligent follow-up on outstanding accounts, and prompt resolution of customer inquiries.
The role requires extensive interaction with families, insurance companies, government agencies, and healthcare professionals.Work Schedule:
Full-Time, Eligible for Benefits (Monday-Friday, Daytime Hours)
Work Environment:
Initially on-site for training, with potential for remote work based on performance metrics.
Why Join Nationwide Children's Hospital?
At Nationwide Children's Hospital, you will experience a unique environment that fosters a sense of belonging and purpose. Our commitment to Diversity, Equity, and Inclusion is woven into our core values, and we are dedicated to creating an inclusive atmosphere for all employees.
We seek individuals who embody these values and are eager to contribute to our mission of improving children's lives.
With a workforce of 16,000, we rely on each team member to make a difference in the lives of children, both locally and globally.Our collaborative culture is vital in delivering exceptional care and advancing groundbreaking research.
Key Responsibilities:
- Ensure timely and accurate billing for all patient accounts, submitting claims within established timelines.
- Process secondary and tertiary claims promptly following primary payer payments.
- Conduct collection activities on outstanding accounts and utilize various tools for effective follow-up.
- Investigate and resolve discrepancies in claims payments, ensuring restitution where necessary.
- Review and correct claims based on payer feedback to facilitate resubmission.
- Manage adjustments for third-party payers efficiently and maintain accurate documentation.
- Collaborate with internal auditors during payer audits to maximize collection efforts.
- Act as a liaison between the hospital and insurance providers to address billing issues.
- Stay informed about payer requirements and regulations through ongoing education and training.
- Participate in departmental task forces and maintain a broad knowledge base to support various functions.
Qualifications:
Education:
High school diploma or GED required; Associate's degree preferred.
Experience:
A minimum of 2-3 years in medical billing, claims follow-up, and customer service is essential. Familiarity with medical terminology, claim forms, third-party contracts, and reimbursement policies is required. Proficiency in data entry and experience with office software is necessary.
Skills:
Strong problem-solving abilities, excellent communication skills, and organizational skills are vital for success in this role. The ability to follow detailed instructions and maintain a high level of accuracy is crucial.
The responsibilities outlined above represent the general nature and level of work performed by individuals in this position. This is not an exhaustive list of duties and may be subject to change as needed.
