Billing Specialist II

Shawnee Health Service•Carterville, IL

6d•$18 - $20

About The Position

Shawnee Health is seeking a Billing Specialist II for its Shawnee Alliance Billing office. The position reports directly to the Revenue Cycle Director. The specialist handles medical billing activities, including posting charges, payments, and adjustments; following up on accounts receivable and insurance denials; and discussing balances with patients or responsible parties. The role also responds to medical service requests and telephone inquiries, routes patients to appropriate staff, and follows confidentiality requirements and organizational policies.

Requirements

High school diploma.
Knowledge of Medicare, Medicaid, and commercial billing guidelines is preferred.

Nice To Haves

Knowledge of Medicare, Medicaid, and commercial billing guidelines.

Responsibilities

Promptly and professionally answer, screen, and process medical service requests and telephone inquiries while adhering to confidentiality policies.
Complete SFA applications proficiently and pass annual testing for SFA application processing.
Refer patients to appropriate staff according to their requests and established protocols, including triage, medical records, patient care coordinators, case management, and ACA staff.
Complete assigned training through the learning management system and other required resources.
Meet Shawnee Health Service and department benchmarks and quality indicators as monitored through audits or recordings.
Support organizational changes and provide coverage as needed during high-volume periods or staff shortages.
Post charges, payments, and adjustments for medical services across provider specialties and payer types in a timely manner, using patient encounter information and physician and medical-record notes as directed.
Maintain a comprehensive understanding of coding rules and regulations from CMS, AMA, ADA, and Medicaid.
Follow up promptly on accounts receivable financial classes and work insurance-carrier denials.
Discuss accounts with patients or responsible parties and work self-pay balances remaining after insurance in accordance with Shawnee Health Service credit and collection policy.
Maintain an excellent understanding of Shawnee Health Service policies and procedures.