Position Summary

Billing Specialist will work at the HMC Business Office and will be assigned to report to a Supervisor within the Business Office. The position is responsible for working collegially with the Business Office back-office staff and/or front-office staff in the physician practice(s) to achieve organizational objectives and goals. Will maintain an efficient billing process for the handling of

patient accounts within their assigned practice(s); exhibit proficiency in all aspects of the Business Office functions. Will perform and maintain a “Best Practice” billing process and workflow. Serve as a resource for practice office staff regarding demographic, insurance, and lab process training. Will assist patients with regards to insurance and benefit information. Will demonstrate and provide excellent customer service, ensuring patient satisfaction. Focus on continued process improvement for both practice and Business Office functions. Must be flexible and may be required to assist at other locations for coverage issues as necessary. Good understanding of billing and collection practices and laws. Maintains good attendance and attends all required staff meetings.

Primary Position Responsibilities

Maintains a complete understanding of the billing functions, required software programs, and a working knowledge of all payer contractual requirements, particularly initial claim filing periods. Utilizes all (Facility) software systems in accordance with Patient Accounts and/or Facility protocols. Responsible for the accurate entry of charges, reconciliation of daily office charges and offsite procedures and visits, with attention to demographics and code compatibility, maintaining a 99% accuracy rate, and performs end-of-day proof of charges entered. Responsible for handling patient billing calls and/or questions from patients regarding billing and insurance benefits and online patient inquiries while demonstrating a thorough understanding of patient bills. Responsible for addressing and resolving issues relating to assigned patient accounts. Utilizes Daily Tasking Process to maintain an efficient system for the daily electronic submission of claims, identifying errors and making the necessary corrections to ensure timely submission to payers. Ensures all unbilled/pending encounters are completed or corrected on a daily basis. Completes all tasks on the assigned tasking queue on a daily basis. Works with the Billing Supervisor to develop and implement bill edits and prevent denials. Responsible for denial management processes for assigned billing and practice areas. Performs monthly review of charges, prints necessary reports, troubleshoots billing issues, and notifies appropriate person(s) of any discrepancies. Meets all productivity and quality standards as set by the Director of the Business Office and is responsible for any other duties as assigned.

Qualifications

Minimum Education: Required: High School Diploma Preferred: Associate’s Degree in Business Administration or technical school certificate of three (3) years Patient Accounting Experience
Minimum Years of Experience (Amount, Type and Variation): Required: 1 year related medical experience Preferred: 2 or more years physician office billing onsite or in centralized environment
License, Registry or Certification: Required: None Preferred: None
Knowledge, Skills and/or Abilities: Required: Knowledge and understanding of Governmental and non-governmental billing regulations required. Understanding of ICD 9 and ICD 10 coding as well as CPT coding structure required. Ability to type, use computer equipment and other office machines Detail oriented, flexible, and able to multitask Knowledge of all local financial assistance programs, insurance processing, charge entry, personal balance collection Strong customer service abilities and able to communicate well with stakeholders Must be flexible to assist at other locations for coverage issues when required. Ability to work well individually and collaborate in a team environment with all individuals in the revenue cycle process Preferred: Medical office experience and familiarity with medical terminology preferred.