What are the responsibilities and job description for the Billing Specialist III position at Puyallup Tribal Health Authority?
Description
Position Close Date: April 3, 2025
The PUYALLUP TRIBAL HEALTH AUTHORITY, located in Tacoma, Washington is seeking an experienced Billing Specialist III. This position is responsible for performing all data entry and clerical functions to process patient billings, insurance eligibility, claims, and payments.
“It is the mission of the Puyallup Tribal Health Authority to provide quality healthcare and promote wellness in a culturally appropriate manner".
We offer an outstanding workplace, competitive market based salary, and benefits packages including:
- Monday – Friday schedule
- Medical/Dental/Vision benefits – monthly premiums paid 100% for employees
- 18 annual paid holidays
- Generous paid sick and vacation accruals
- 401(k) with annual profit sharing
- Life & AD&D insurance coverage
- PTHA is an approved loan repayment site for various programs
- Employee Assistance Program
- Excellent work/home life balance
ESSENTIAL JOB FUNCTIONS:
- Detailed knowledge and application of ICD-10, CPT and HCPTS coding systems.
- Process Medicaid eligibility letters daily.
- Prepare and print bills for spend down requests.
- Print CMS 1500’s and ADA forms weekly, prepare for mailing.
- Interpret and apply insurance eligibility and billing requirements.
- Organize and file explanation of benefits from insurance companies monthly.
- Post incoming payments and denials from insurance companies with a 100 % accuracy rate.
- Accurately process heavy volume of dental and orthodontic claims, verifying correct insurance and current procedure codes have been assigned with less than 5% error during quarterly sampling.
- Reviewed denied claims during posting; claims denied due to coding issues forward to the appropriate coder, claims denied due to billing error, correct and rebill.
- Process aging account reports assigned on a monthly basis.
- Assist in training staff on new systems and processes as directed.
- Identify problems with claims and provide suggestions/solutions to resolve issue.
- Upload 837 claims daily, Download 835 payments daily.
- Review new insurance report as assigned to you daily and reprocess any claims not billed to the payer.
- Process weekly checks received and prepare for posting to the register. In absence of supervisor post checks to check register and deliver checks to accounting staff.
- Coordinate and assign daily work flow to department staff.
- Ability to process reports as needed for billing and payment.
- Verify and sign time sheets during supervisor absence, as needed and requested.
- May assume supervisor role and responsibilities in absence of Department Supervisor.
- Process monthly closing and other required reports in supervisors’ absence.
Requirements
- High School diploma or GED.
- Six (6) years' recent experience within the last seven (7) years, in a medical billing department.
- Two (2) years Medicare billing experience within the last seven (7) years.
- Experience with electronic health record systems.
Salary : $23 - $31
