Job Description
Description Job Description Job Summary Responsible for all phases of billing/account follow-up using accepted billing practices to ensure thorough and consistent account resolution to promote financial health. This position ensures appropriate reimbursement and days in Accounts Receivable with timely account follow-up and resolution of outstanding charges owed by third party payors. Responsible for all areas of billing and account follow-up including claims submission, account follow-up with insurance payors, and resolution of reimbursement issues for multi-facility, multi-specialty organization.
Essential Functions - Resolves insurance claim rejections/denials, and non-payment of claims by payors.
- Identifies trends in billing and follow-up, in order to expedite resolution of insurance accounts and identify delays in processing.
- Drafts appeals to insurance companies for reimbursement of monies owed.
- Maintains daily account, follow-up work lists within department while maintaining organization’s productivity standards.
- Ensures compliance and claims processed in accordance with payer contracts and policies, as well as to settle claims as appropriate.
- Identifies, researches and resolves: credit balances, missing payments, payer recoupments, and unposted cash as it pertains to billing account follow-up.
- Processes and maintain correspondence received from patients and insurance companies as it pertains to correct and timely billing of claims, and receipt of payment.
- Handles submission of issues to coding for review to ensure organizational and revenue cycle processes are followed.
- Communicates appropriately with insurance companies, patients, co-workers and supervisors.
- Performs other duties as assigned.
Qualifications Education - High School Diploma Required: or equivalent And
- Associate Degree Preferred.
Experience - Minimum of 2 years Required: Experience in a billing or insurance account follow-up capacity and
- Formal training or college coursework from a medical coding accredited school, specific to medical billing in lieu of experience may be considered and
- Required: Medical terminology experience and
- Required: Knowledge of insurance processes and billing guidelines regulations and
- Preferred: Coding knowledge and
- Preferred: Epic experience
Credentials - Preferred: Medical Billing Certificate or
- Preferred: Certified Revenue Cycle Representative or
- Preferred: HealthStream Badge
Skills - Proficient use of computers including Microsoft Office applications (Word, Excel, PowerPoint, etc.) (Required)
- Skilled in 10-key by touch and keyboarding (Required)
- Ability to operate general office equipment (Required)
- Excellent verbal and written communication skills (Required)
- Excellent attention to detail and ability to multi-task (Required)
- Ability to work with minimal supervision, independently, as well as in a collaborative team setting (Required)
- Strong organizational skills with the ability to prioritize and meet deadlines (Required)
- Knowledge of Commercial and/or Government Payors (Required)
- Ability to identify, research, and resolve credit balances, missing payments and unposted cash and payer recoupments, as it pertains to billing account follow-up. (Required)
- Ability to work remotely with minimal oversight, independently, as well as in a collaborative team setting. (Required)
Working Conditions Lifting
- Consistently operates computer and other office equipment.
- Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects.
- Sedentary work.
Environmental Conditions
- Predominantly operates in an office environment.
Mental/Visual
- Ability to communicate and exchange accurate information.
- The worker is required to have close visual acuity to perform an activity such as: preparing and analyzing data and figures; transcribing; viewing a computer terminal; extensive reading.
PeaceHealth is seeking a Billing/Follow-up Specialist - Commercial Billing for a Full Time, 1.00 FTE, Day position. The salary range for this job opening at PeaceHealth is $19.14 – $28.72. The hiring rate is dependent upon several factors, including but not limited to education, training, work experience, terms of any applicable collective bargaining agreement, seniority, etc.
PeaceHealth is committed to the overall wellbeing of our caregivers: physical, emotional, financial, social, and spiritual. We offer caregivers a competitive and comprehensive total rewards package. Some of the many benefits included in this package are full medical/dental/vision coverage; 403b retirement plan employer base and matching contributions; paid time off; employer-paid life and disability insurance with additional buyup coverage options; tuition and continuing education reimbursement; wellness benefits, and expanded EAP and mental health program.
See how PeaceHealth is committed to
For full consideration of your skills and abilities, please attach a current resume with your application. EEO Affirmative Action Employer/Vets/Disabled in accordance with applicable local, state or federal laws.
Job Tags
Full time, Work experience placement, Work at office, Local area,