What are the responsibilities and job description for the Billing Specialist I - HB position at Phelps Health?
Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri.
No matter where you start with us, we’re committed to taking our team to the top. If you’re ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family.
General Summary
No matter where you start with us, we’re committed to taking our team to the top. If you’re ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family.
General Summary
- The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts. Reports to the Billing Supervisor.
- Enters information necessary for insurance claims such as patient, insurance, and insurance ID. Insures claim information in complete and accurate.
- Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
- Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
- Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
- Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
- Follows HIPAA guidelines in handling patient information.
- May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
- Understand managed care authorizations and limits to coverage such as number of visits.
- Verify patient benefits eligibility and coverage as needed.
- Prepares and submits secondary claims upon processing by primary insurer.
- High School Diploma or GED required.
- Medical billing experience highly preferred. Experience in billing software and electronic data submission preferred.
- Certification/License
- Ability to receive and express detailed information through oral communications, visual acuity, and the ability to read and understand written directions. Normal mental concentration with repetitive operations for a long period of time. Ability to stand, walk, sit, and reach. Occasionally lifts and transports items weighing up to ten (10) pounds. .
- Standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases.
