Job Description: Billing Specialist II

Reports to: Revenue Cycle Manager

Job Purpose:

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

Position Information:

Hours Weekly: 40

Monday – Thursday: 7:30 am – 5:00 pm

Friday: 8:00 am – 3:00 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 Revenue Cycle Manager in Accounts Receivable (A/R)
Assists 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 positive interactions.
Communicate professionally and timely with internal and external customers
Demonstrate friendliness by smiling and making eye contact when greeting all customers.
Provide helpful assistance in anticipating and responding to the needs of our customers.
Collaborate with customers in planning and decision making to result in optimal solutions.
Ability to stay calm under pressure and deal effectively with difficult people

Education and Experience Requirements:

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

Specific Skills:

Knowledge and acquired usage of Microsoft standard programs; in particular, Microsoft Word and Excel
Good communication skills, particularly with inter-departmental communications

Key Competencies

Verbal and written communication skills
Professional personal presentation
Standard PC usage
Office organization
Reliability

Basic Competencies:

Internet - using the internet for filing claims, gathering information, and communicating
Spreadsheets – knowledge and ability to create, modify, and electronically transmit
Email and fax machine knowledge and familiarity

Tools:

Desktop computers
Laptop computers
iPad
Scanner
Fax machine
Copy Machine
Postage Meter

Technology:

Internet
Microsoft Word and Excel
IMS (program software) – onsite training

Texas Hearing Institute

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Billing Specialist