Hospital Billing Specialist

1. Filing Claims

a. Review insurance claims for accuracy and completeness in order to submit clean claims to various third-party payers electronically or via paper claim forms.

b. Request needed information from various departments to complete claim information as necessary.

c. Prepare monthly claim by applying required condition and value codes for series/recurring claims (P/T & O/T).

2. Claim Follow-up

a. Responsible for follow-up of filed claims to ensure timely payment from time of claim submission.

b. Correct claims that are returned by insurance requiring correction.

c. Provide additional claim information when requested by third-party payers, including medical record documentation.

d. Handle rejections/sanctions from third-party payers. Prepare appeal letters to dispute denials from insurance carriers.

e. Communicate nay problem areas of billing to supervisor.

3. Account Maintenance

a. Responsible, daily, for file maintenance on all accounts.

b. Ensure that documentation is clear and concise regarding activity on account.

c. Ensure that documentation is dated and initialed.

d. Responsible to review and work all claims that have failed claim edits in Star according to the most current procedure.

e. Request adjustments daily and timely.

4. Customer Service

a. Assist customers/families with billing questions on patient responsible balances, copayments, deductibles, write-offs.

b. Interpret Explanation of Benefits, copays, coinsurance, deductibles, and non-covered services in order to explain patient responsibility balances.

c. Handle correspondence related to customer inquiries in a professional manner, always being willing to go the extra mile, and documenting all correspondence in the notes/comments section of the current Patient Accounting System.

5. Answer Telephones

a. Answer phone within 3 rings.

b. Respond to all customers in a friendly, courteous and timely manner.

c. Document all interaction with customers in the notes/comments section of the current Patient Accounting system.

6. Review insurance bulletins and correspondence for changes in payer requirements

a. Responsible for reviewing payer bulletins and communications in order to keep abreast of payer changes in order to submit compliant claims.

b. Discuss and confer with peers regarding the interpretation of changes in payer requirements with final direction of interpretation from supervisor.

7. Client Billing

a. Moving charges

b. Responsible for sending out monthly statements.

c. Answer questions and follow-up on payments.

8. Responsible for daily opening and/ or closing of the office.

9. Act as a phone and facility back up receptionist, keeping phone and front desk covered at all times.

10. Comply with all facility and departmental policies and guidelines regarding safety.

11. Maintain Resident, Patient and Facility Confidentiality.

12. Know and comply with Residents’ Rights rules.

13. Treat residents, patients, visitors and co-workers with kindness, dignity and respect at all times.

14. Attend and participate in orientation, training, mandatory education, in-services, staff meetings and education courses as instructed to further improve knowledge and skills.

15. Promote teamwork; encourage others to work to the best of their ability; assist with training of new co- workers, if needed.

16. Have a positive attitude; accept change willingly; follow facility rules, regulations and job assignments; accept suggestions well for work improvement; perform well with minimum supervision; do what is requested without complaint; cooperate with supervisor and show respect at all times; speak well of company and job.

17. Lack of absences and tardiness; give timely notice of absences; take allowed time for breaks.

18. Follow company dress code.

19. Other duties may include:

a. Completing charge entry for hospital, ER, SWB, OBS, & IP admits.

b. Assisting with overflow facility switchboard telephone calls.

c. Assisting with all returned mail address corrections and contacting patients for new information.

d. Assisting with EOM processes whenever necessary each month for Central Supply.

e. Other appropriate duties as they relate to the overall management of the department.

Job Type: Full-time

Pay: $20.00 - $28.00 per hour

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Monday to Friday

Ability to Commute:

• Stanley, ND 58784 (Required)

Ability to Relocate:

• Stanley, ND 58784: Relocate before starting work (Required)

Work Location: In person

Salary : $20 - $28