Billing Specialist I
About The Position
The Billing Specialist I is responsible for billing and collection functions, including filing claims for institutional and professional services provided by the Hospital Authority of Miller County. Working under the direction of Patient Financial Services Leadership, the Biller handles duties across the claims 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 prepares, reviews, and submits inpatient and outpatient claims; follows up on unpaid claims; processes payments and account adjustments; and supports denials, appeals, and collections. It also involves coordinating with Patient Access Representatives, maintaining knowledge of payer requirements and billing systems, and completing assigned revenue cycle projects. The position operates in a hospital environment and may involve changing tasks, fluctuating workloads, periods of high stress, exposure to noise, bright lights, limited hazardous substances, body fluids, or infectious organisms, and overtime 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 work in a fast-paced 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 meet the position’s physical demands, including standing and walking for most of the shift; bending, stooping, pushing, pulling, and lifting or carrying items as described in the posting.
- Ability to hear alarms, telephone calls, and normal speaking voices; near-normal vision; good manual dexterity and eye-hand-foot coordination; and ability to perform repetitive tasks or motions.
- Ability to work overtime as needed.
Nice To Haves
- Experience in healthcare revenue cycle management.
- Knowledge of commercial and government payer policies, regulations, and requirements.
- Experience understanding and reconciling EOBs.
- Experience with Cerner.
- Additional language skills.
Responsibilities
- Prepare, review, and transmit inpatient and outpatient 837 claims using billing software for electronic and paper submission.
- Follow up on unpaid claims aged over 30 days and record claim status in the billing software.
- Coordinate with Patient Access Representatives to verify and understand patient benefits and eligibility.
- Process account payments, adjustments, reconciliations, and refunds within insurance company timeframes.
- Participate in required departmental training, which may be provided by Relias, HomeTown Health, the Georgia Hospital Association, Medicaid, Medicare, and other trade organizations.
- Resolve denials, appeals, and collection issues using problem-solving skills.
- Write Level 1 appeals for denied claims.
- Complete special Revenue Cycle Management projects as required or assigned.
- Perform other duties as assigned and comply with departmental policies and procedures.
- Maintain current knowledge in areas of responsibility and attend staff meetings, mandatory in-services, and competency evaluations.
- Maintain patient confidentiality and comply with organizational policies, regulatory requirements, and ethical business practices.
- Report suspected illegal or unethical behavior to a supervisor or the Compliance Officer.
- Provide friendly, professional, and cooperative service to patients, coworkers, and other departments.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
