BILLING SPECIALIST
Company: Universal Health Services, Inc.
Location: Spokane
Posted on: March 17, 2023
Job Description:
Responsibilities
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
Qualifications
ADDITIONAL REQUIREMENTS
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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