Billing Specialist (4347)
About The Position
The Billing Specialist is responsible for maintaining a current knowledge of insurance carrier and/or state program claims filing policies and procedures. This role involves verifying patient demographics and financial coverage, updating information as needed, and researching and verifying refunds/recoupments. The specialist will adjust patient accounts, verify the accuracy of claim forms, and research and correct unassigned patient charges. They will also maintain patient accounts, apply discounts, appeal rejected service charges, and process claims/vouchers. Obtaining pre-certifications, prior-authorizations, or referrals, and verifying motor vehicle or accident information are also key duties. The role requires maintaining work queues with claim errors, assisting insurance carriers and patients with information and understanding billing processes, and making payment arrangements. Additionally, the Billing Specialist will assist outside providers, vendors, and employees with billing-related matters, communicate and support training for billing staff, and comply with all confidentiality regulations. Maintaining payor and plan information, managing multiple priorities, communicating professionally, demonstrating excellent judgment, and committing to the mission and values of Waco Family Medicine are essential. Other duties include assisting with scheduling, processing billing statements, providing payment arrangement follow-up, handling mail, and providing backup support for other billing staff.
Requirements
- High School Diploma or Equivalent required
- Computer literacy
- Knowledge of ICD-10 CM/CPT coding
- Knowledge of medical office billing and collection practices
- Knowledge of federal/state/local financial assistance programs
- Strong interpersonal skills
- Strong oral communication skills
- Strong written communication skills
- Excellent telephone skills
- Excellent customer service skills
- Visual and auditory accuracy
- Continuous use of computer, calculator
- Long periods of sitting and walking
- Frequent use of telephone
- Frequent use of stepladder
- Continuous repetitive grasping and manipulation of both hands
- Continuous conversational communication
- Occasional reaching, standing, squatting, bending, kneeling, twisting and climbing
- Occasional carrying, lifting, pushing and pulling of up to 10 Lbs
- Infrequent use of personal transportation
- Working in a frequently noise environment
- Continuously working in a tight area
- Understand/carry out simple/detailed, oral/written instructions
- Memorize and retain instructions
- Read and interpret detailed specifications
Nice To Haves
- College Hours preferred
Responsibilities
- Maintain a current knowledge of insurance carrier and/or state program claims filing policies and procedures
- Verify patient demographics and financial coverage; update as needed
- Research and verify patient and/or insurance company and/or state program refunds/recoupments
- Adjust patients accounts to reflect changes in payment responsibility
- Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and/or state programs
- Research patient charges not automatically assigned to selected insurance carriers and/or state programs, make corrections and assign manually
- Maintain patient accounts; give GHC program discounts and/or other adjustments as needed
- Appeal service charges rejected by selected insurance carriers and/or state programs and resubmit amended claim forms
- Process claims/vouchers as needed for insurance plans and/or state programs
- Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
- Verify motor vehicle or accident information with patient’s insurance carrier
- Maintain work ques with claim errors
- Assist insurance carriers and/or state programs to acquire supplemental patient information needed to process claims
- Assist patients to understand fees for services and billing processes
- Assist patients to make payment arrangements and find financial assistance
- Assist outside providers and vendors to obtain physician billing information
- Assist employees to understand policies and procedures related to billing matters
- Communicate and support training issues with billing staff
- Comply with all regulations related to confidentiality of patient information
- Maintain and/or create new payor and plans as needed
- Able to manage multiple priorities and manage stress appropriately
- Communicates appropriately and clearly with a pleasant and professional manner to all
- Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
- Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
- Maintain certifications and website passwords as applicable
- Assist in scheduling patient appointments
- Process billing statements and balance notification letters to patients
- Assist patients to make payments on owed balances
- Provide follow-up on patient’s payment arrangements
- Assist with daily mail duties
- Provide backup support for clerks and other billing staff as needed
- Other duties as assigned by supervisor
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
