Billing Specialist
Job Summary :
The Billing Specialist has responsibility for third-party claims and collections process for clients / patients. Primary responsibilities include timely claim generation, sending follow up correspondence with payors, patient invoicing, collections, and reporting.
Supervisory Responsibilities :
Duties & Responsibilities :
Prepares and submits clean claims daily to third party payers using billing softwareCoordinates with team members to ensure prior authorizations have been obtained and credentialing requirements have been met prior to billingAudits data to identify discrepancies that could lead to denials or underpaymentsPerforms basic accounting principles in the billing function including account reconciliationTracks, manages, and reports on overall revenue cycle management (RCM) process to ensure timely paymentsReviews and submits client invoices, work with clients' families to address any questions regarding client responsibility; escalates concerns to leadership as neededSets up patient payment plans and works A / R outstanding collection accountsIdentifies and works client coordination of benefits issues with multi-payers per client as they ariseIdentifies, resolves, and settles outstanding balances on denials / underpayment / overpaymentsInterprets electronic remittance advice (ERAs), post payments, and own financial data integrity for clients / patientsAnswers patient or insurance telephone / email inquiriesMaintains weekly and monthly dashboards / reportsCollaborates with RCM team on process / workflow improvementRemains current on payor-specific billing / coding guidelines and collaborates with operations and clinical teams to implement changes, as neededAdheres to HIPAA guidelines and regulationsMaintains productivity and quality standards as determined by the departmentPerforms all other duties as assignedRequired Education, Certifications, Skills & Abilities :
Bachelor's degree (preferred)2 years of medical billing / collections experienceExcellent problem-solving skillsExcellent organizational skillsAdditional Requirements :
Must have a valid driver's licenseMust be willing to work at different SMF locations if requestedMaintains confidentiality and privacy in accordance with HIPAA and SMF policiesUnderstands and adheres to SMF Compliance Standards, Code of Conduct and Conflict of Interest policyExhibits professional conduct at all timesAbility to set priorities and manage time effectively to meet deadlines; work independently and cooperatively in a multicultural, multilingual environment; work flexible hours; effectively interact with community agencies, patients, and clinical personnel.Training Requirements :
The Billing Specialist, in conjunction with other staff, will be responsible for attending all mandatory training that appropriately matches the skill set and position they are performing.Physical Requirements :
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions)
Ability to sit for long periods of timeConstantly operates a computer and other office productivity machinery, such as calculator, copy machine, and computer printerAbility to physically write and visually readSandhills Medical Foundation, Inc. has been providing quality, comprehensive health care since 1977. We are a Federally Qualified Health Center (FQHC) serving residents of Chesterfield, Kershaw, Lancaster, and Sumter counties. The mission of Sandhills Medical Foundation, Inc. is to be responsive to community healthcare needs by providing quality, comprehensive, and cost effective healthcare.
401k401k matchingHealth InsuranceDental InsuranceLife InsuranceVision InsurancePTO and Sick LeaveEmployee EAP Program
