Billing Specialist

Billing And Follow-Up PositionThis position will be responsible for performing billing and follow-up functions, including the investigation of payment delays, resulting from no response, denied, rejected and/or pending claims with the objective of appropriately maximizing reimbursements and ensuring that claims are paid in a timely manner. This position requires strong decision-making ability around complex claims processing workflows and requires utilization of data coming from multiple resources.It is the obligation of each employee of Boone County Hospital (BCH) to abide by and promote BCH's mission, values, Code of Conduct, Standards of Behavior, policies, procedures, and related practices. This includes policies relating to Compliance, Infection Control and Safety.Boone County Hospital is committed to following all federal guidelines related to privacy and security.

All employees will be held to the highest standard of confidentiality and will be required to annually sign an employee confidentiality agreement that outlines the rules and expectation for every BCH employee. Failure to abide by these guidelines could lead to disciplinary action including termination.High Incumbent has access to restricted or confidential patient information and must comply with the terms of the BCH privacy & security policies as it applies to their job.Boone County Hospital has developed standards for behavior expectations of all employees. Please refer to the Boone County Hospital Standards of Behavior.Essential Functions:Resolve billing errors and edits to ensure all claims are filed in a timely mannerEnsure all claims are accurately transmitted daily and all appropriate documentation is sent when requiredVerify eligibility and claims status on unpaid claimsReview payment denials and discrepancies and take appropriate action to correct the accounts/claims.Respond to customer service inquiriesPerform charge corrections when necessary to ensure services previously billed incorrectly are billed out correctlySubmit replacement, cancel and appeal claims to third party payersProvide timely feedback to management of identified claims issues, repetitive errors, and payer trends to expedite claims adjudicationWork accounts in assigned queues in accordance with departmental guidelinesContact patients for needed information so claims are processed /paid in a timely mannerWork directly with third party payers and internal/external customers toward effective claims resolutionOther duties as assigned by the Patient Financial Service DirectorMinimum Knowledge, Skills and Abilities Required:Prefer one year of experience within a hospital or clinic environment, an insurance company, managed care organization or other financial service setting, performing medical claims processing and or financial counseling.High School Diploma or GEDInterpersonal skillsWritten and verbal communicationBasic computer skillsMotivation, teamwork and professionalismCustomer/Patient focusedPlanning and organizational skillsPhysical Activity Requirements:Operate office equipment such as computers, printers, copy machine, calculator, facsimile, multi-line phone system, and scanners.Working Conditions:Typical working conditions include sitting at a desk for extended periods, while working on a computer or talking on the phone.Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.Vision must be correctable to view computer screens and read printed information.

Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, and ability to adjust focus.Hearing must be in the normal range for telephone contacts and other conversations.The above is intended to describe the general content of and requirements for this job. It is not intended to be a complete statement of duties, responsibilities, or requirements.