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Company: Universal Health Services, Inc.
Location: Spokane
Posted on: March 17, 2023

Job Description:


REPORTS TO: Business Office Director SUMMARY STATEMENT & PURPOSEThe Billing Specialist, a key position in the Revenue Cycle, manages the submittal of clean claims to third party payers, either electronically or by paper, including accurate and timely claim creation, follow-up and correspondence with providers, and insurance inquiries/correspondence. The incumbent will assist in the clarification and development of process improvements, account statements, preparing and reviewing financial reports, physician billing, and assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues. All employees are expected to be pleasant, respectful, and courteous in all interactions with patients, families, staff, and visitors of the Hospital, as well as being a positive representative of INBH at all times. MINIMUM QUALIFICATIONS

A minimum of one (1) year experience in insurance billing or experience in a healthcare environment required, or a combination of education, training, and/or experience in a healthcare environment.Oriented and sensitive to patient needs and aware of the importance of maintaining strictest confidentiality of patients and employees, adhering to all HIPAA guidelines and regulations. PREFERRED QUALIFICATIONS
Knowledge of Medicare, Medicaid, and HMO desiredExperience with insurance portals and business software programs preferred EMPLOYEE RATES AND BENEFIT
  • One hundred and sixty-eight hours paid time off per year to include 6 major holidays. Employees (and their families) are covered by medical, dental, vision, and basic life insurance with FSA/HSA available.401(k) plan with company matchingTuition reimbursement

    This position may require flexible hours, to include overtime. SPECIFIC PERFORMANCE RESPONSIBILITIESAll functions are essential functions unless otherwise noted.The job functions of this position are not limited to the duties listed below. Ensure all facility and physician accounts are prepared for proper billing and account billing productivity standards are met. Review the daily unbilled report and make corrections when required; ensuring accuracy of clean claim data; including authorizations, admit service, revenue codes, diagnoses, contract rates, and benefit reimbursement method.Prepare and submit timely insurance billings to primary, secondary, and tertiary payers. Monitor electronic billings to ensure acceptance through clearinghouse or intermediary. Work any rejections and forward any unresolved issues to collectors for assistance. Issue adjusted, corrected, and/or rebilled claims to third party payers. Ensure all accounts have correct contractual adjustments posted, either automated or manual, and manual adjustments are noted. Posts adjustments, transfer of responsibility (secondary insurance billing, patient responsibility, or collections), and refunds, as necessary. Respond to correspondence and complete re-bill requests within 72 hours of receipt. Work closely with physicians billing agency and reconciling cash. Notify collector and document account when payments are denied. Denial and insurance follow-up management. Analyze accounts to determine account is netted down based on contract rate.Act as back-up for the Data Processor on an "as needed" basis, posting the daily deposit and reconciling the FCR. PHYSICAL & SENSORY REQUIREMENTS, WORK ENVIRONMENT & CONDITIONS: To perform this job successfully, the employee must be able to perform job duties satisfactorily. The qualification requirements listed below are representative of the knowledge, skill, and/or abilities sought. Language Skills: The employee must be able to present information effectively, orally or in writing, and must respond to questions from patients, referral sources, health care professionals, and the public. The ability to read, analyze, interpret and clearly communicate payer information, is critical. Must be computer literate. Must have the ability to maintain patient accounting information, record statistical data, accurately complete forms, and write/communicate data in accordance with standard policies and procedures. Ability to interpret insurance benefits and relay information to physicians, nurses and patients. Ability to read, write and follow directions. Reasoning Ability: Must have the ability to define problems, collect data, and establish facts. The ability to understand basic accounting principles (i.e., adding, subtracting, debits and credits). The employee should be able to interpret information from a variety of concrete and abstract sources and draw valid conclusions. Ability to establish priorities effectively and to be self-directed and capable of working without direct supervision. Physical Demands: While performing the duties of this job, the employee is regularly required to stand, walk, and sit; reach with hands and arms, use hands to finger, handle or feel objects and operate standard office equipment; and talk or hear in person as well as the ability to talk and hear over a telephone are major components of this position. Regularly required to lift and/or move up to 25 pounds (i.e., laptop computers, program materials, patient charts). Specific vision abilities required by this job include close, color, and peripheral vision and ability to adjust focus (frequent computer work).
    Knowledge of all code procedures.Knowledge of computers and business software.Knowledge of CPT coding and insurance billing.Skill in organizing and prioritizing workloads to meet deadlines.Skill in telephone etiquette and paging procedures.Effective oral and written communication skills.Ability to communicate effectively with patients and co-workers.Ability to adhere to safety policies and procedures.Ability to use good judgment and to maintain confidentiality of information.Ability to work as a team player.Ability to demonstrate tact, resourcefulness, patience and dedication.Ability to accept direction and adhere to policies and procedures.Ability to recognize the importance of adapting to the various patient age groups (adolescent, adult and geriatric).Ability to work in a fast-paced environment.Ability to react calmly and effectively in emergency situations.Ability to meet corporate deadlines. All employees of Inland Northwest Behavioral Health who have direct or indirect access to patient health information must treat that information with the strictest confidentiality.

Keywords: Universal Health Services, Inc., Spokane , BILLING SPECIALIST, Accounting, Auditing , Spokane, Washington

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