BILLING SPECIALIST I

The Hospital Authority of Miller County•Colquitt, GA

10h•Onsite

About The Position

The Billing Specialist I is responsible for billing and collection functions, also referred to as claims filing, for institutional and professional services provided by the Hospital Authority of Miller County (HAMC) to its patients. The position works under the direction of Patient Financial Services Leadership and performs duties across the claim life cycle. This is a full-time, on-site position scheduled Monday through Friday, 8:00 a.m. to 4:30 p.m. The role requires a high school diploma or equivalent. Healthcare revenue cycle experience, knowledge of payer policies and requirements, EOB reconciliation, and Cerner experience are preferred but not required. The employee is expected to comply with organizational policies, maintain patient confidentiality, complete required training, and support HAMC’s mission of delivering superior, safe, cost-effective healthcare. Duties and responsibilities may change as needed.

Requirements

High school diploma or equivalent.
Ability to communicate in English verbally and in writing.
Strong written and verbal communication skills.
Basic computer skills.
Critical-thinking and problem-solving skills.
Ability to thrive in a fast-paced work environment with excellent attention to detail.
Ability to understand and use electronic health record and billing software systems, Microsoft Office Suites, and other office equipment.
Ability to perform the physical activities listed for the role, including standing, walking, bending, stooping, pushing, pulling, and lifting or carrying items, with assistance where specified.

Nice To Haves

Experience in various areas of healthcare revenue cycle management.
Experience and knowledge of commercial and government payer policies, regulations, and requirements.
Proficiency in understanding and reconciling EOBs.
Experience with Cerner.
Additional language skills.

Responsibilities

Prepare, review, and transmit 837 inpatient and outpatient claims through billing software for electronic and paper claim submission.
Follow up on unpaid claims aged over 30 days and document their status in billing software.
Coordinate with Patient Access Representatives to verify and understand patient benefits and eligibility.
Process account payments, adjustments, reconciliations, and refunds within the timeframes set by insurance companies.
Participate in required departmental training, which may include training provided by Relias, HomeTown Health, the Georgia Hospital Association, Medicaid, Medicare, and other trade organizations.
Address denials, appeals, and collections using problem-solving skills.
Apply knowledge of Medicaid, Medicare, HMOs, PPOs, CMOs, and other payer requirements.
Use electronic health record and billing software systems, Microsoft Office Suites, and other office equipment.
Write Level 1 appeals for denied claims.
Complete special Revenue Cycle Management projects as required or assigned.
Perform other duties as assigned and complete job functions according to departmental policies and procedures.
Maintain current knowledge in areas of responsibility, attend staff meetings, and complete mandatory in-services, educational requirements, and competency evaluations on time.
Follow the organization's Code of Conduct, regulatory requirements, ethical business practices, dress code, timekeeping procedures, and patient confidentiality requirements.
Communicate and uphold the organization's mission, and interact with coworkers and others in a friendly, helpful, professional manner.
Report suspected illegal or unethical behavior to a supervisor or the Compliance Officer and use ePHI access only as necessary for assigned job functions.