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