What are the responsibilities and job description for the Clinic Billing Specialist; 8AM -4:30PM; 80 Hours position at Bothwell Regional Health Center?
JOB TITLE: Clinic Billing Specialist
JOB CODE: 6481
JOB HOURS: 8:00 AM to 4:30 PM
JOB SUMMARY:
The Clinic Billing Specialist is responsible for computer and billing systems, for electronic insurance processing and follow-up, & for setting up payment plans and handling collection activities.
The Billing Specialist reports directly to the Director of Clinic Financials.
QUALIFICATIONS:
1. Education:
a.) High School education or equivalent with on-the-job training for Clinic specific systems.
b.) Added training in data processing, computer systems and typing is desired.
2. Licensure/Certification:
a.) N/A
3. Work Experience:
a.) Prefer two to three years’ experience in data processing systems and Medical Office Insurance preparation.
RESPONSIBILITIES/JOB DUTIES:
1. Billing all primary and secondary claims as assigned for all clinics daily reports as
assigned.
2. Work remittance advices for denials and possible resubmission or corrected
claims.
3. Respond to patient phone inquiry as needed. Reconcile the account and
understand what the balance consists of (i.e. deductible, co-insurance, co-pay, etc.).
4. Follow up with insurance payers on claim resolution to have accounts resolved in
a timely manner to either zero or self-pay balance.
5. Process credit balances as assigned.
6. Document in Meditech system an action taken on patient’s account.
7. Set up payment plans and/or collect self-pay balances on patient accounts.
REQUIRED STAFF COMPETENCIES:
1. Demonstrates support for organizational and departmental mission.
2. Supports and demonstrates knowledge of the Strategic Plan and the Hospital Key
Initiatives.
3. Fosters and promotes teamwork within department and the organization as a
whole.
4. Works to resolves conflicts constructively and in a timely manner.
5. Ability to communicate effectively and simply with every customer and co-
worker.
6. Ability to display a positive, courteous and friendly attitude toward all contacts.
7. Ability to build good relationships with others based upon a sustained effort of
mutual support toward common goals.
8. Ability to exercise good judgment, reasoning and concentration to detail and to
take personal accountabilities for all actions in carrying out job duties.
9. Is customer focused and committed to Quality and Process Improvement with a
strong desire to provide service excellence.
10. Possesses and displays a strong knowledge and understanding of the standards of
practice for their position including, if and when applicable, commensurate computer skills; population specific and general competencies; organizational skills, time and project management.
11. Possesses a vigorous and enthusiastic desire to learn and to grow both personally
and professionally, and to improve one's skills in order to deliver the best possible care for our customers.
WORKING CONDITIONS:
1. Clinic setting.
2. Generally sedentary position.
3. Subject to frequent interruptions.
4. Required to multi-task.
5. Exposed to stressful situations.
6. Other office duties as needed.
7. Must maintain high level of confidentiality.
JOB CODE: 6481
JOB HOURS: 8:00 AM to 4:30 PM
JOB SUMMARY:
The Clinic Billing Specialist is responsible for computer and billing systems, for electronic insurance processing and follow-up, & for setting up payment plans and handling collection activities.
The Billing Specialist reports directly to the Director of Clinic Financials.
QUALIFICATIONS:
1. Education:
a.) High School education or equivalent with on-the-job training for Clinic specific systems.
b.) Added training in data processing, computer systems and typing is desired.
2. Licensure/Certification:
a.) N/A
3. Work Experience:
a.) Prefer two to three years’ experience in data processing systems and Medical Office Insurance preparation.
RESPONSIBILITIES/JOB DUTIES:
1. Billing all primary and secondary claims as assigned for all clinics daily reports as
assigned.
2. Work remittance advices for denials and possible resubmission or corrected
claims.
3. Respond to patient phone inquiry as needed. Reconcile the account and
understand what the balance consists of (i.e. deductible, co-insurance, co-pay, etc.).
4. Follow up with insurance payers on claim resolution to have accounts resolved in
a timely manner to either zero or self-pay balance.
5. Process credit balances as assigned.
6. Document in Meditech system an action taken on patient’s account.
7. Set up payment plans and/or collect self-pay balances on patient accounts.
REQUIRED STAFF COMPETENCIES:
1. Demonstrates support for organizational and departmental mission.
2. Supports and demonstrates knowledge of the Strategic Plan and the Hospital Key
Initiatives.
3. Fosters and promotes teamwork within department and the organization as a
whole.
4. Works to resolves conflicts constructively and in a timely manner.
5. Ability to communicate effectively and simply with every customer and co-
worker.
6. Ability to display a positive, courteous and friendly attitude toward all contacts.
7. Ability to build good relationships with others based upon a sustained effort of
mutual support toward common goals.
8. Ability to exercise good judgment, reasoning and concentration to detail and to
take personal accountabilities for all actions in carrying out job duties.
9. Is customer focused and committed to Quality and Process Improvement with a
strong desire to provide service excellence.
10. Possesses and displays a strong knowledge and understanding of the standards of
practice for their position including, if and when applicable, commensurate computer skills; population specific and general competencies; organizational skills, time and project management.
11. Possesses a vigorous and enthusiastic desire to learn and to grow both personally
and professionally, and to improve one's skills in order to deliver the best possible care for our customers.
WORKING CONDITIONS:
1. Clinic setting.
2. Generally sedentary position.
3. Subject to frequent interruptions.
4. Required to multi-task.
5. Exposed to stressful situations.
6. Other office duties as needed.
7. Must maintain high level of confidentiality.
