Billing Specialist

HealthNet•Indianapolis, IN

3d•Hybrid

About The Position

The Billing Specialist at the HealthNet Administration location reviews accounts for assigned payers to reduce accounts receivables and enhance cash flow. The billing specialist follows proper insurance processes, timely follow-up, and resolution of accounts, and provides feedback to management when internal problems resulting in nonpayment of claims are detected. This position is responsible for all aspects of electronic or paper claim submission. Contact patients to make payment plan arrangements. Work with collection agencies to resolve outstanding patient balances. Serve as liaison to third party payers, patients and families, providers and staff and referral sources for communicating billing information. Initiate collection with all insurance carriers on electronically submitted and/or paper claims. Assist with posting mail receipts, Medicare, Medicaid, HMO and PPO payment listings against individual patient accounts. Review third party payment listings and takes appropriate action on accounts in order to avoid account aging. Make recommendations/decisions on account resolution. Review billing for accuracy and completeness. Review and corrects billing and collection problems arising in patient care facilities. Maintain the confidentiality of any patient medical, financial, or personal information and other information records and data to which there is access.

Requirements

Requires High School Diploma or GED.
Understanding of both Federally Qualified Health Centers and Commercial billing and collections.
Knowledge and understanding of Medicare/Medicaid regulations and billing requirements.
Participate in monthly training programs for staff on policies and procedures related to billing and collection, including proper coding, use of sliding fee scales, and financial screening.
Strong written and verbal communication skills.
Ability to work independently, handle detail and work efficiently and accurately under pressure.
Ability to multitask.
Ability to handle sensitive patient data and must maintain a high degree of confidentiality.
Excellent customer service/listening skills.
Reliable transportation required.

Nice To Haves

Certification in coding & billing preferred.
Experience in third party billing/collection with in-depth knowledge of specific third-party payer requirements.
Working knowledge of medical terminology and basic medical coding practices (UBC; CPT4; HCPCS; ICD-9).
Knowledge and proper application of remote electronic inquiry systems for Medicare; Medicaid; Blue Cross and/or all other Commercial payers.
Ability to process adjustment claims to Medicaid and Medicare payers on resolution of credit balance claims.
OB/GYN coding experience preferred.
Bilingual in Spanish or Burmese preferred, but not required.

Responsibilities

Reviews accounts for assigned payers to reduce accounts receivables and enhance cash flow.
Follows proper insurance processes, timely follow-up, and resolution of accounts.
Provides feedback to management when internal problems resulting in nonpayment of claims are detected.
Responsible for all aspects of electronic or paper claim submission.
Contacts patients to make payment plan arrangements.
Works with collection agencies to resolve outstanding patient balances.
Serves as liaison to third party payers, patients and families, providers and staff and referral sources for communicating billing information.
Initiates collection with all insurance carriers on electronically submitted and/or paper claims.
Assists with posting mail receipts, Medicare, Medicaid, HMO and PPO payment listings against individual patient accounts.
Reviews third party payment listings and takes appropriate action on accounts in order to avoid account aging.
Makes recommendations/decisions on account resolution.
Reviews billing for accuracy and completeness.
Reviews and corrects billing and collection problems arising in patient care facilities.
Maintains the confidentiality of any patient medical, financial, or personal information and other information records and data to which there is access.