Position Summary: This position is responsible for prioritizing and batching material for data entry which requires knowledge of technical material. Must be capable of high-volume data entry. The Billing Specialist will review, post, and submit claims that are compiled on a daily basis through the Practice Management System. This position will also be responsible for statement processing and posting payments and adjustments to patient accounts and assisting with Sliding Fee Scale applications and audit processes.
The following information is intended to be representative of the essential functions performed by incumbents in this position and is not all-inclusive.
1. Process insurance claims to various types of insurance and self-pay patients
2. Research and communicate with insurance and third parties regarding claim denials, making corrections as needed.
3. Verifies patient eligibility and obtains referrals necessary for billing as needed.
4. Reconcile lab vendor charges and correct discrepancies.
5. Make necessary billing/coding corrections and refile denied claims for reprocessing.
6. Process and post patient payments.
7. Answer patient inquiries regarding account status.
8. Identify, research, and resolve patient billing issues.
9. Review and research bad address files.
10. Assist with provider insurance credentialing duties as needed.
11. Assist with Sliding Fee Scale application and audit processes.
12. Assist NHC personnel when needed as time permits.
13. Assist with reports to maintain federal funding as requested.
14. Assist with updating policies, procedures, and forms.
15. Participate in staff meetings and other meetings as instructed.
16. Maintain confidentiality within the workplace and within the community.
17. Handle protected health information in a manner consistent with the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
18. Adhere to the Mission and Values of NHC.
19. May be asked to perform other duties that align with NHC’s mission, including but not limited to participation on clinical committees, providing education, Quality Review, and/or other activities.
1. Excellent communication skills
2. Attention to detail
3. Computer knowledge
4. Medical Terminology
5. Experience in coding and charge entry