What are the responsibilities and job description for the Billing Specialist position at Down East Community Hospital?
Description
JOB SUMMARY AND SCOPE
To seek reimbursement for hospital patient accounts by accurately billing third party payors and patients, and performing follow-up as necessary to secure payment for each patient account.
ESSENTIAL JOB FUNCTIONS
- Reviews bills daily as they are printed and edits bills as necessary in preparation for submission to third party payors
- Reviews daily rejections from third party payors and re-submits within 5 business days.
- Contacts third party payors to seek information and to solve problems that arise during the reimbursement process
- Meets with patients to solve problems with patient accounts
- Reviews a monthly aged trial balance in order to prevent accounts from aging past filing limits and takes corrective action
- Manage assigned accounts to an average of 50-60 days in AR, or as assigned.
- Keeps abreast of new laws, compliance and changes in third party billing process
- Reviews various reports for overpayments, late posted charges, incorrectly posted charges and payments, and takes corrective action, being mindful of applicable filing limits.
- Processes credit balances due to overpayments in accordance with hospital policy
- Works with appropriate hospital departments to coordinate the reimbursement process
- Accepts cash payments and prepares receipts
- Processes hospital mail
- Seeks out needed information by staying informed and involved by attending meetings, reading memos, policies, meeting minutes, newsletters, email and other appropriate information in a timely manner.
- Reliable attendance and punctuality, including observing appropriate break times and extending a a
- Performs duties in a safe manner, in compliance with all safety policies and procedures
- Complies with the Code of Conduct and all appropriate policies and procedures
- Other duties, as assigned, that are relevant to the position and department
Requirements
MINIMUM REQUIREMENTS
- Associates Degree in Business or two years related experience
PHYSICAL EFFORT AND ENVIRONMENT
Moderate: Occasionally lifts up to 25 pounds independently. Occasionally pushes/pulls 100 pounds. Stands or walks often.
EXPOSURE RISK
Exposure Category III: Employee not reasonably expected to be at risk for exposure to blood borne pathogens.
QUALITY IMPROVEMENT
- Maintains current knowledge of the hospital-wide Quality Improvement Program.
- Collaborates with management to improve the effectiveness of the department through the Quality Improvement plans and processes.
- Participates in the departmental and hospital-wide Quality Improvement activities as directed by the manager.
COMPLIANCE
- Adheres to the federal, state, and local statutes and regulations.
- Adheres to the Compliance Program policies and procedures of Down East Community.
- Adheres to all Privacy and Security policies and procedures of Down East Community.
- Communicates any concern related to compliance issues to manager of department or Compliance Officer.
- Communicates any concern related to confidentiality issues to the Privacy Officer.
*DECH is an equal opportunity employer.
