What are the responsibilities and job description for the Outpatient Therapy Billing Specialist position at Hot Springs Health Program, Inc.?
The Outpatient Therapy Billing Specialist is the main link between patients and third-party insurance companies. They monitor and address aged accounts for insurance(s) and/or contracts as assigned. They manage referrals, schedule patients, verify insurance, and submit claims. They are responsible for all Outpatient Therapy billing duties. They provide services that reflect the mission, standards, and philosophy of the Hot Springs Health Program. They may aid Physical Therapists with non-skilled tasks such as ambulation or balance safety, or assist with patient positioning as instructed by the therapist.
Essential Job Duties
Essential Job Duties
- Answers phone pleasantly, obtaining the necessary information for accurate messages.
- Fields new referrals immediately.
- Calls health insurance companies to confirm benefits.
- Contacts referred patients with an estimated expense for physical therapy to schedule while minimizing vacancies on the schedule.
- Assists patients with questions regarding health insurance, pricing, and hours.
- Assists staff with payment and adjustment questions.
- Collects & posts payments from patients per patient’s insurance coverage or self-pay status.
- Reviews and interprets explanation of benefits (EOB) from insurance carriers to post appropriate payment and denial codes daily.
- Demonstrates knowledge of insurance payer guidelines. Identifies invoices with secondary payers and takes the appropriate action to ensure they are sent to secondary carriers.
- Enters alphabetic, numeric, or symbolic data such as denial codes and rejections from all payers into the practice management system.
- Runs daily, weekly, and monthly reports from multiple sources to ensure accurate posting of payments.
- Verifies insurance, submits claims, addresses claim errors & denials, collects & post payments, and is responsible for all therapy billing duties.
Behavioral Expectations
- Maturity and ability to deal effectively with job demands.
- Respect for the confidentiality of all aspects of patient care and business matters of the Hot Springs Health Program.
- Professional attitude and appearance.
- Motivated and self-driven to improve the performance of the department.
- Abide by the Hot Springs Health Program policies and procedures located in the employee handbook. Abide by OSHA, HIPAA, and safety standards. Abide by all federal, state, and local regulations.
Education and Experience
A. Education: High School graduate or GED required. Prior experience in a clinical setting is preferred.
B. Experience: Billing experience is preferred.
C. Other: Valid N.C. Driver’s License, and dependable transportation.
Current CPR certification is preferred
Salary : $14
