Insurance Billing Specialist

PUTNAM COUNTY HOSPITAL•Greencastle, IN

6d•Onsite

About The Position

This position is responsible for the day to day team operations of the Patient Accounts billing systems. Works directly with Manager of Patient Accounts to ensure timely claims submission, accounts receivable follow-up and cash posting applications.

Requirements

High School diploma or equivalent requires.
3+ yrs. of experience in hospital office working with insurance claims processing involving CPT, HCPCS, ICD-10 and CMS Regulations.
Familiarity with CMS1500 and UB04 claim form completion
Strong analytical, oral written communication skills.
Familiarity with health insurance and other third party billing practices and guidelines
Proficient in DDE and Indiana Medicaid systems
Working knowledge of medical terminology
Must demonstrate the ability to use tact and diplomacy in dealing with others

Responsibilities

Facilitates Patient Financial Services compliance with regulatory processes and procedures.
Review LCD ( local coverage determination ) guidelines to ensure that all compliance and regulatory processes are met before claim is released. Coordinate with medical records for correct and accurate diagnoses on claims.
Acts as a resource to billing staff for problem solving difficult accounts; through information system issues, training and billing systems. Monitors training and provides general guidance regarding billing regulations and work flow processes.
Ensures that all problem-solving issues occurs at the lowest level possible that would impact other departments within the facility with a positive outcome.
Reviews, analyzing, researching, implementing, and monitoring regulation and contract changes that affect the billing system programming and billing reimbursement procedures.
Coordinate all daily closing and billing files. Export claims to billing system to produce daily workloads.
Coordinate government payor files into proper billing systems (Care Medic) and (DDE). Complete all credit quarterly 838 reports for Medicare
Track all late charges to insure the import files are complete and accurate.
Monitor all yearly CPT and revenue codes updates to insure compliant billing guidelines.
Troubleshoot billing system issues. Works with Management to resolve and implement all changes needed. Communicate changes to other staff members.
Assists Management in work flow processes and staff responsibilities, job descriptions and operating procedures.
Review weekly statements to patient to ensure accuracy and monitor any system issue.
Adheres to hospital policies and protocol
Proactively communicates with all staff members in an accurate and timely manner
Strives to meet or exceed the expectations of patients, visitors, and other staff members in the top quality and excellence.
All other duties as assigned