Billing Specialist

Roosevelt General Hospital • Portales, NM

8d

About The Position

Under general supervision, is responsible for representing Roosevelt General Hospital and RGH Clinic as an exemplary hospital in the region. The Billing Specialist position requires fundamental knowledge of filing insurance claims on UB and HCFA claim form, how insurance companies pay accordingly to contracts established with the hospital, how to read and interrupt an insurance explanation of benefits (EOB), process denials, import charges and do precise follow-up with the insurance company via, phone, email, insurance web sites, etc. at an acceptable volume per day. The Billing Specialist will be the embodiment of the hospital’s mission, vision and values. The Billing Specialist will greet patients or family members upon arrival within the business office and assist them in answering any questions or concerns they may have regarding billing issues. The Billing Specialist will have knowledge of all aspects of the department process from the registration through the billing process.

Requirements

• High school graduate or equivalent
• Six months previous hospital registration, billing and collections, financial counseling, and/or customer service experience required
• Basic computer knowledge
• Typing speed: minimum 40 wpm, computer knowledge

Nice To Haves

• Medical terminology knowledge preferred.
• Knowledge of CPT / ICD- coding helpful.

Responsibilities

• Promote the mission, vision, and values of the organization
• Responsible for all billing functions for assigned financial class(es).
• Account checks
• Tasks
• Denials
• Credit Balances
• Incomplete claims (FinThrive)
• Rejections (FinThrive)
• Held Claims (FinThrive)
• Assist patients with billing inquiries to include explaining the charges, payments, insurance decisions, insurance coverage, coordination of benefits, or any other concerns they may have
• Respond to voicemails within 24 business hours
• Maintain active portal accounts to all assigned payors
• Communicate directly with payor or provider representatives when recurrent issues arise
• Release medical records upon request within 3 days of receipt
• Follow up on any correspondence that may have been received weekly
• Submit revised order requests for accounts that meet criteria
• Participate in weekly billing huddles/discussions
• Participates in data gathering for financial reporting
• Cross train in other Billing Specialist positions to include different payers
• Report frequent billing issues to Billing Lead/Director of Business Office to determine if permanent resolution is available through software systems

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED