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Medical Billing Specialist in Warren, MI at Oakland Regional Hospital

Date Posted: 11/26/2018

Job Snapshot

Job Description

Shift Time: Days
Shift Length: 8 hours
Standard Hours Per Week: 40 hours/week

Role/Position Definition:

Under the general supervision of the billing manager/director, the Medical Billing Specialist is responsible for posting, billing, and collection of all accounts receivables, ensuring timely cash flow for the hospital. Maintains and ensures that all billable procedures are correct and accurate prior to claim submission to all payers. Monitors all billing for timely submission to all payer guidelines and stays informed of changes in billing procedures that impact the filling of claims.

Duties and Responsibilities:

A. Under the general supervision of the billing manager/director, the medical billing specialist is responsible for posting, billing, and collection of all accounts receivables, ensuring timely cash flow for the hospital.
B. Maintains and updates patient demographic information related to the process of clean claim submissions.
C. Maintains and ensures that all billable procedures are correct and accurate prior to claim submission to all payers.
D. Identifies and resolves claim errors prior to claim being submitted to payers.
E. Works rejections on remittance advices when received and submits proper documentation and/or adjusted claim.
F. Monitors all billing for timely submission to all payer guidelines and stays informed of changes in billing procedures that impact the filling of claims.
G. Monitors all outstanding accounts receivables and follows up with insurance companies in a timely manner.
H. Reports status of accounts receivables to billing manager upon request.
I. Performs cash posting duties as required by billing manager/director and maintains all cash posting to patient accounts accurately and timely.
J. Maintains HIPPA and other lawful practices when billing payers.
K. Develop and maintain a good working rapport with interdepartmental personnel as well as other department areas within the facility.
L. Performs all other duties as assigned.

Job Requirements

Qualifications/Position Requirements:

A. Education/Experience

  • High School Diploma / GED required.
  • 2+ years of hospital/facility medical billing experience strongly preferred.
  • Experienced with computers and/or medical software required.
  • Experience with Medicare and third party claims
  • Previous experience with health insurance plans preferred

B. Licensure/Certification

  • Certified Medical Biller Certificate strongly preferred

C. Knowledge, Skills and Abilities

  • Knowledge of UB04 and CMS 1500 claim forms required.
  • Knowledge of CPT, DRG, HCPCS, and ICD-10 coding required.
  • Knowledge of medical billing software required.
  • Knowledge of medical terminology, including common procedures.
  • Read and understand patient medical records and other treatment documentation; interpret medical provider notes and comments, including the use of common acronyms and abbreviations.
  • Identify discrepancies between medical information and financial charges.
  • Utilize standard business equipment, including computer hardware and software.
  • Analyze and resolve problems and complaints.
  • Strong communication and organization skills required
  • Strong computer knowledge required
  • Proficiency in the use of Hospital Information Systems required
  • Proficiency in the use of Microsoft Office required
  • Establish and maintain cooperative working relationships with others including physicians, nurses, administrators, managers, auditors, and other health care industry personnel.

Work Environment:

Office Setting
Definitions: Occasionally = .25 – 2.5 hours/day
Frequently = 2.5 – 5.5 hours/day
Continuously = 5.5 – 8 hours/day
A. Sitting – Continuously.
B. Standing – Occasionally.
C. Walking – Occasionally.
D. Lifting/Carrying 0-10lbs – Occasionally.
E. Lifting/Carrying 10-20lbs – Occasionally.
F. Lifting/Carrying 20-50lbs – Rarely.
G. Lifting/Carrying 50-100lbs – Rarely.
H. Lifting/Carrying over 100lbs – Rarely.
I. Reach Above – Occasionally.
J. Bend/Stoop – Occasionally.
K. Use hands for pushing/pulling – Occasionally.
L. Use hands for fine manipulation – Frequently.
M. Travel – May travel to locations throughout the organization - Occasionally.
N. Public Contact – Interaction with public in person and over phone - Continuously.
O. Blood/Body Fluid Exposure – None.
P. Chemicals Exposure – None.
Q. Computer – Use of computer, typing & viewing - Continuously.