Medical Billing Specialist II

We are expanding our team to serve the needs of our community in the Lake of the Ozarks, Missouri area! Central Ozarks Medical Center (COMC) is excited to announce an opening for a Medical Billing Specialist II!

COMC is a Missouri non-profit, federally qualified health center that has served Pulaski, Laclede, Camden and Miller counties for over 40 years. Our goal is to provide the highest quality, affordable healthcare to the communities we serve. COMC is looking for a mission-driven team member who is comfortable working with patients with diverse backgrounds. Applicant must be a motivated, self-starter able to quickly adapt to new and changing conditions while maintaining a professional demeanor.

COMC offers a robust compensation and benefits package, (including medical, dental, vision, life insurance, long and short-term disability, and retirement). We have an excellent staff and a wonderful patient population. The scenic Lake Ozark area is a great location for raising a family and enjoying a variety of outdoor recreational activities.

We believe that health care is a right and not a privilege. Based on that belief, we have evolved into a health center that offers high-quality health care regardless of age, race, sex, disability, religion or ability to pay. Our mission continues to be successful because of committed, dedicated and caring staff.

Responsibilities: The Billing Specialist is responsible for collecting, coding, and submitting claims. Must be able to answer patient inquiries on patient accounts. Reports to the Billing Manager.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Enters information that is necessary for insurance claims such as patient, insurance, and insurance ID. Ensure claims information is complete and accurate.
• Submits insurance claims to clearing house or individual insurance companies electronically or via paper UB04 and or CMS-1500 form.
• Answers patient questions on patient responsibility portions, copays, deductibles, write-off’s, etc. Resolves patient complaints or explains why certain services are not covered.
• Reviews and appeals unpaid or denied claims in a timely manner.
• Follows up with insurance companies on unpaid or rejected claims. Resolves the issues and resubmits the claim timely.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect the necessary information that is needed to accompany the appeal letter.
• Acts as a patient account representative. Work with patient to establish payment plan for past due accounts in accordance with our payment plan policy.
• Will do quarterly coding audits at the direction of the Billing Manager or Director of Revenue Cycle.
• Follows HIPPA guidelines in handling patient information.
• Follow up on and perform soft collections on unpaid accounts via telephone, mail, text or email.
• Prepare and submit secondary claims to the insurance company timely.
• Understand Managed Care authorizations and limits of coverage such as number of visits allowed.
• Verify patient benefits and eligibility as needed.
• Look up ICD10 diagnosis and CPT/CDT treatment codes from the online service or using the traditional coding reference book.
• Follow State, Federal, and local guidelines. Example: Medicare and Medicaid Guidelines

Qualifications Requirements: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  A Coding/Billing Certification is REQUIRED.  Medical/Dental billing and coding experience is highly preferred. The requirements listed below are representative of the knowledge, skill, and/or ability required. Must be vaccinated to work at Central Ozark Medical Center.

Education and/or experience: High school diploma or equivalent. Billing experience of two years in medical/dental billing. Coding/Billing Certification is REQUIRED. Must be able to operate a computer and billing software. Able to type or keyboard 45 wpm preferred and ability to operate a calculator proficiently. Familiarity with CPT/CDT and ICD coding systems and medical terminology is required.

Language Skills: Ability to read and write. Ability to respond to common inquiries or complaints from customers and regulatory agencies. Ability to effectively present information to Billing Manager and/or Director of Revenue Cycle.

Mathematical Skills: Must be able to add and subtract, multiply and divide accurately.

Reasoning Ability: Ability to define problems, collect data, establish facts, and draw valid conclusions, follow federal, state and health care regulations.

Other Skills and Abilities: Able to read and interpret technical bulletins and software documentation. Must possess very strong communications and interpersonal skills, good telephone personality and must like working with people. Able to work effectively in a fast-paced environment. Must have a willingness to learn, interpret and apply new skills and take direction from other team members. Able to organize information and manage time efficiently.

Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This includes moderate physical effort consisting of occasionally lifting or moving over 35 pounds of weight.

Travel Requirement: To fulfill the responsibility of the position travel to all COMC locations may be required. Employee must have valid Missouri driver’s license and availability of a motor vehicle.

Work Environment: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Knowledge of, and compliance with, HIPAA and 340B regulations is required. Confidentiality of patient information is mandatory.

The noise level in the work environment is usually moderate.

About COMC:
Central Ozarks Medical Center has been providing quality health care in Central Missouri since 1979. Central Ozarks Medical Center’s staff members are committed to leading the way to healthier communities. COMC offers a wide range of services based on the needs of the communities we serve. We pride ourselves on offering high quality healthcare regardless of insurance status. If you are uninsured and would like to look at healthcare options, our staff are more than willing to help you navigate the process.

Our Mission
COMC is committed to leading the way to healthier communities by reducing barriers to care, ensuring access for all, and creating a positive working environment of engaged team members with a shared goal.

Our Values
At COMC, we use the following strategically anchored values to guide all our actions:

Selfless Service: We lead by example
• Be Accountable
• Treat others with respect
• Assume the best
• Act with self-awareness

Approachable: We communicate openly
• Disagree with respect
• Ask questions
• Communicate effectively
• Value different perspectives
• Share a unified message with one voice

Resilient: We enable and Inspire
• Celebrate success and accept setbacks
• Remove barriers
• Ensure inclusivity and diversity

Passionate: We promote community
• Build Strong relationships
• Be a good partner
• Identify opportunities

Responsive: We take action
• Look for solutions
• Challenge the status que
• Learn from the past, look to the future
• Act with good intentions

Resourceful: We collaborate
• Interact with colleagues
• Promote multi-disciplinary teams
• Serve as good stewards of COMC resources
• Act with self-awareness