What are the responsibilities and job description for the Patient Accounts - Billing Specialist - Full-Time position at Wilson Health?
Wilson Health is looking for a direct hire Physician Billing Specialist for Commercial Payers in the Patient Accounting Department located in Sidney, Ohio (North Dayton, Ohio) area.
Key Perks and Benefits:
- Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
- Generous paid time off program beginning day one
- Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance
- H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses
- Company Paid Life, Short Term and Long Term Disability Insurance
- Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance
- Industry leading retirement plan- employer contributions begin day one, no waiting period for participation
- Tuition Assistance Program
Employment Status: Full Time (FT=36 hours)
Working Hours: 40 hours a week (80 hours per pay period)
Schedule: Monday - Friday (No Weekend or Holidays)
Shift: 1st shift
Position Reports to: Manager of Patient Accounts
Department Description: Wilson Health's Patients' Account Department is responsible for handling the hospital billing and collection aspects of the patient’s care during the service date (The date/date(s) when care was provided to the patient from the hospital or provider).
Job Summary: The Billing Specialist is responsible for releasing insurance claims electronically and mails hard copy UB/1500 claims as required. The Billing Specialist will follow up on unpaid claims which include all Non Medicare, Medicaid or BWC claims and rebill or appeal claims as indicated.
Essential Duties & Responsibilities:
- Billing of claims through Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits.
- Submits claim electronically or hard copy for MSP claims with appropriate information from the primary payer.
- Bills secondary, tertiary, etc. claims electronically or mails the UB/1500 with EOB as required by Payer.
- Monitors claims using the Medicare and or Quadax online system
- Works closely with all departments throughout the hospital regarding charges and/or late charges.
- Responsible for the follow up of submitted claims to primary, secondary, and tertiary payers
- Works the 30 day and out worklist in EMR and contacts Payers via phone or Payer website regarding no pays.
- Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons. Biller or Collector will follow up on the Appeal.
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Works with Case Management and Medical Records regarding RAC audits, other audits, and inpatient denials.
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Works mail as it applies to the Biller or Collector to secure payment.
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Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal
Other Skills and Abilities:
- Accurate typing skills, computer keyboard skills and data entry. Knowledge of medical terminology, CPT and HCPCS codes. Calculator skills. Ability to work in a highly stressful environment. Ability to adapt to change. Knowledge of Excel. Organization and prioritizing skills. Ability to communicate with co-workers.
Qualifications:
- 1 Year Previous hospital billing experience. Medical terminology and understanding of cpt and icd 10 codes.
- High school diploma or general education degree (GED)
Mission & Vision & Values:
- Improve the health and wellness of the community by delivering compassionate, quality care.
- Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
- A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.
EOE (Equal Opportunity Employer)
