Billing Specialist I

The Hospital Authority of Miller County•Colquitt, GA

About The Position

This position is responsible for the billing and collection functions (a/k/a claims filing) of the institutional and professional services rendered by the Hospital Authority of Miller County (HAMC) to its patients. The Biller will work under the direction of Patient Financial Services Leadership to carry out duties pertaining to the claim’s life-cycle.

Requirements

Ability to communicate in English, both verbally and in writing.
Strong written and verbal skills.
Basic Computer Skills
High school diploma or equivalent required
Performs all job responsibilities in alignment with the mission and vision of the organization.
Performs other duties as required and completes all job functions as per departmental policies and procedures.
Maintains current knowledge in present areas of responsibility (i.e., self-education, attends ongoing educational programs).
Attends staff meetings and completes mandatory in-services and requirements and competency evaluations on time.
Wears protective clothing and equipment as appropriate.
Follows Code of Conduct policy.
Adheres to dress code; appearance is neat and clean.
Completes annual educational requirements.
Maintains regulatory requirements.
Maintains patient confidentiality at all times.
Reports to work on time and as scheduled; completes work within designated time.
Wears identification when on duty; uses computerized time clock system correctly.
Completes in-services and returns in a timely fashion.
Attends annual review and/or skills fair and department in-services, as scheduled.
Attempts to end conversations and other interactions in a positive manner; leaves others with a good impression of the Hospital Authority of Miller County and its employees.
Complies with all organizational policies regarding ethical business practices.
Communicates the mission statement of the organization.
Always treat others in a friendly, helpful manner.
Refers co-workers to proper sources when unable to provide an answer.
Interacts with others in a professional and friendly manner.
Takes interest in others and always gives full cooperation to fellow workers.
Always maintains an open line of communication with other departments.
Thoroughly familiar with the hospital and the services it offers.
It is the responsibility of every employee of HAMC to comply with federal, state and local laws and regulations, as well as, HAMC Policies and Procedures.
Every employee is help accountable to participate in, comply with and report concerns to his or her supervisor or the Compliance Officer if illegal or unethical behavior is suspected.
As an employee of HAMC, you have been granted user access to applicable ePHI systems based on your position.
This user or role-based access is intended to give you the minimum necessary access to perform your job function(s) only and should be used only as applicable.
Have near normal hearing: Hear alarms/telephone/normal speaking voice.
Have near normal vision: Clarity of vision (both near and far), ability to distinguish colors.
Have good manual dexterity.
Have good eye-hand foot coordination.
Ability to perform repetitive tasks/motion.
Continuously within shift (67-100%): Standing, Walking.
Frequently within shift (34-66%): Bending/Stooping, Pushing/Pulling, Lift/carry up to 20lbs, Lift/carry greater than 20 lbs. with assistance.
Occasionally within shift (1-33%): Sitting, Climbing, Twist at waist, Lift/Carry greater than 50 lbs. with assistance, Reaching above shoulder.

Nice To Haves

Experience in various areas of healthcare revenue cycle management preferred but not required
Experience and knowledge in commercial and government payer policies, regulations, and requirements preferred but not required
Proficient in understanding and reconciling EOB’s preferred but not required
Experience in Cerner preferred, but not required
Additional languages preferred.

Responsibilities

Prepare, review and transmit 837 inpatient and outpatient claims using the billing software for electronic and paper claim submission
Follow-up on unpaid claims aged over 30+ days, notating status in the billing software
Coordinate with the Patient Access Representatives to verify and understand the patient’s benefits and eligibility
Process account payments, adjustments, reconciliations, and refunds within the timeframe set by the insurance company
Participate in required departmental training which may include training provided by Relias, HomeTown Health, Georgia Hospital Association, Medicaid, Medicare and various other trade organizations
Demonstrate problem-solving skills in the areas of denials, appeals, and collections
Demonstrate knowledge of Medicaid, Medicare, HMOs, PPOs, CMOs and other payer’s requirements
Demonstrate proper understanding of Electronic Health Record and Billing software systems, Microsoft Office Suites and other office equipment
Demonstrate ability to write appeals for denied claims at Level 1
Must possess critical thinking and problem-solving skills
Demonstrate the ability to thrive in a fast-paced work environment while giving excellent attention to detail
Complete special Revenue Cycle Management projects as required or assigned
Other responsibilities as assigned