Billing Specialist

POSITION SUMMARY :

This position is primarily responsible for all patient billing, payments, and accounts

receivable financial reporting for CareSouth. In addition, this position has direct

responsibility for assisting the Billing Manager with all patient-related financial reporting

both internal and external). Duties include entering payment data through an electronic

keyboard for daily transactions, with a high level of speed and accuracy. Responsible for all

provider billing accounts receivable including the posting of all payments, collection of

delinquent accounts, and receivable from third-party payers. Primary liaison in the

identification and implementation of MIS billing system changes with Front Desk staff.

PRIMARY RESPONSIBILITIES :

1. Knowledge and understanding of Employee Handbook.

2. Carry out the meaning of the CSMD Mission and Vision statements.

3. Practice a culture of safety to reduce or prevent the risk of injury, claims, loss, or

liability by utilizing the Risk Management and Infection Control Plan.

4. Perform responsibilities with a high-quality standard to yield improved

compliance, quality, and patient outcome measures by adhering to the Quality

Improvement Plan.

5. Be present and ready for work as scheduled.

6. Attend in-service training, departmental meetings, and community events.

7. Work cohesively with team members.

8. Post payments to each account to ensure proper credit; compares the

transaction report to actual encounter forms processed for that day.

9. Enter new and / or updated information for reduction of payment through

payments and approved credits.

10. On a daily basis, resolves payment transactions and discrepancies.

11. Responsible for processing all receipts by working closely with other clinical

staff.

12. Review delinquent patients' accounts on a timely basis; prepares and send out

delinquent notices accordingly. Update patient database files with correct

addresses and insurance information.

13. Recommend and participate in the development of plans and methods to collect

current and aged accounts receivable.

14. Assist in the preparation of monthly aged accounts receivable reports.

15. Prepare billings and sends out billings according to established procedures.

16. Follow up on billings submitted to insurers. Responds to all requests for patient

claims information (e.g., insurance companies, attorneys, patients, etc.)

17. Generate financial reports dealing with insurance patient accounts and deposits

for submission to Chief Finance Officer.

18. Maintains confidentiality of workplace information according to the policies and

procedures of the center.

19. Generate daily reports for submission to the Chief Finance Officer of claims

generated, number sent out, dollar amount, etc.

20. Works closely with Billing Assistant / Clerk, Billing Manager, and the Chief Finance

Officer in setting up and monitoring electronic billing procedures.

21. Controls the use of material and supplies necessary to perform job duties.

Maintains proper use of the equipment and proper inventory management of supplies.

22. Works professionally as a team member in conjunction with other department

employees and the center.

23. Complies with policies and procedures.

24. Work closely with patients in the resolution of billing issues.

25. Perform other duties as assigned by the supervisor.

TRAINING :

1. Relias Track A Non-Clinical

2. Relias CareSouth Onboarding

PERFORMANCE MANAGEMENT EVALUATION TYPE

Administrative and Programmatic

REQUIREMENTS :

1. EDUCATION / LICENSURE :

The candidate is required to be a High School Graduate or Equivalent, and a graduate of an

approved school for advanced training and / or education. A current Billing certification

and / or related area with advanced knowledge of billing functions, procedures, and hands-on computer operations in health care or medical environment preferred.

2. TRAINING AND EXPERIENCE :

The position requires a minimum of three years of medical billing experience, including a

minimum of one year in a primary care setting / environment. Special Qualifications :

Required to be able to successfully complete established competencies for the position

within designated probationary period. S / He should have the ability to solve practical

problems, deal with a variety of concrete variables in situations where only limited

standardization exists. Able to interpret a variety of instructions furnished in written, oral,

diagram or schedule form.

3. JOB KNOWLEDGE :

Effective communication skills : both oral and written. Computer skills needed : Ability to

work with others within a team to ensure quality patient care. S / He should have a

strong desire to learn medical terminology and procedures. Working knowledge of

software packages and applications used in providers billing and accounts receivable

functions. The billing specialist needs to be proficient in personal computer usage. Ability

to concentrate and pay close attention to details. Ability to organize, prioritize and work

independently as well as schedule and produce work in a timely manner.

SUPERVISES : None.

PHYSICAL REQUIREMENTS :

1. Visual acuity - always

2. Hand-eye coordination - always

3. Work is primarily sedentary. Large amounts of time may be spent using a PC and

MIS application.

4. Lifting, Pushing, Pulling - sometimes

5. Stooping, Bending, Sitting - sometimes

6. Walking- frequent; short distances

WORK ENVIRONMENT :

1. Indoor, environmentally controlled

2. Exposure to disease or infections

3. No vibrations

4. Exposure to artificial and / or natural light