Billing Specialist

Job Description : Billing Specialist

Reports to : Senior Revenue Cycle Manager

Job Purpose :

We are a pediatricnon-profit organization seeking a billing specialist to join our professional team.The billing specialist will manage all matters and communications relative toinsurance claims on behalf of Texas Hearing Institute.

Position Information :

Hours Weekly : 40

Monday - Friday : 8 : 00 am - 5 : 00 pm

Starting Salary : Determined by experience.

FLSA Status : Non-exempt

Benefits :

• Health & Dental Insurance
• Life Insurance
• Long Term Disability Insurance
• 403 (b) Retirement Plan
• 12 Paid Holidays
• 21 Paid Time Off Days

Major Responsibilities

Stays focused on maximizing revenue and reducing contractual allowances / discounts / MWS and other (grants) write offs at all times

Files all THI claims. Files all THI appeals, and corrected claims, as needed

Handles all communications with Insurance / Medicaid provider relations re : underpayments and / or denials through to final resolution

Enters and posts all service-related (program) payments into IMS software

Regularly reviews all client accounts and keeps them clean, including notifying clients of balances due, issuing check requests for refunds due, or making necessary adjusting entries.

Assists Senior Revenue Cycle Manager in Accounts Receivable (A / R)

Assists Senior Revenue Cycle Manager with awareness of insurance / Medicaid policy and / or contractual changes, and notifies management and / or program directors as changes occur

Prepare and process insurance claims timely and accurately to government, commercial and managed care payers.

Review and distribute corrected claims

Resolve claim edits via claim edit work queues and / or our external billing software

Other Responsibilities

Acts as backup to THI Verification Specialist and Front Desk (Receptionist) in their absence and / or as needed

Customer Service Standards

Support co-workers and engage in positiveinteractions.

Communicate professionally and timely withinternal and external customers

Demonstrate friendliness by smiling and makingeye contact when greeting all customers.

Provide helpful assistance in anticipating andresponding to the needs of our customers.

Collaborate with customers in planning anddecision making to result in optimal solutions.

Ability to stay calm under pressure and dealeffectively with difficult people

Education and Experience Requirements :

High school diploma

Must have three-plus years of claims (insurance billing) experience

Specific Skills :

Knowledge and acquiredusage of Microsoft standard programs; in particular, Microsoft Word and Excel

Good communication skills,particularly with inter-departmental communications

Key Competencies

Verbal and written communicationskills

Professional personalpresentation

Standard PC usage

Office organization

Reliability

Basic Competencies :

Internet- using the internet for filing claims, gathering information, andcommunicating

Spreadsheets- knowledge and ability to create, modify, and electronically transmit

Emailand fax machine knowledge and familiarity

Tools :

Desktopcomputers

Laptopcomputers

iPad

Scanner

Faxmachine

CopyMachine

PostageMeter

Technology :

Internet

Microsoft Word and Excel

IMS (program software) - onsite training

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