What are the responsibilities and job description for the Billing Specialist position at Bethesda Health Clinic?
JOB DESCRIPTION
TITLE: Billing Specialist
REPORTS TO: Pediatrics Operations Manager
Full job description
Do you want to make a difference in the lives of others while also pursuing a fulfilling career?
Do you love being a leader and overseeing projects and people?
If so, we need you on our team!
Bethesda Pediatrics is looking for a full-time Billing Specialist to join our growing practice! Bethesda is a non-profit clinic providing care for underserved families in the East Texas area. Our mission goes beyond the ordinary, aiming to surprise, delight, and exceed expectations at every turn. We believe in the power of community, fostering meaningful connections, and recognizing the unique value in each individual. If you're ready to embark on a journey where faith, innovation, and empathy are not just buzzwords but guiding principles, then you're in the right place.
As a Christian-based organization, our team comes to work every day ready to make a tangible difference in the community.
General Summary
This position is responsible for ensuring accurate and appropriate data entry of charges, the follow up of claims and posting payments for claims received. Ensure proper insurance verification is completed and denials are promptly reconciled with either the insurance company or responsible party. This position is also responsible for greeting all persons that enter the clinic and answering phone calls in a timely manner.
Duties and Responsibilities
• Provide the best customer service experience for all patients and responsible parties in-person or through phone calls.
• Responsible for claim submissions to both government and commercial payors in accordance with all insurance regulations and requirements.
• Answer customer inquiries regarding billing and insurance issues.
• Provide all necessary documentation required by payors to resolve claim issues or denials, including medical records, prior authorizations, audits, etc.
• Maintain daily productivity levels, as outlined by management.
• Conduct regular reviews of unpaid claims patterns and make recommendations to improve operational efficiency and reduce the occurrence of denials.
• Follow-up on all returned claims and denials in a timely manner as outlined by management.
• Perform eligibility verification and claim status lookup.
• Perform end of day process daily.
• Review and verify accuracy of patient data and billing information
• Analyze and research all denials and over or under payments.
• Prepare various weekly and monthly reports regarding AR, denial percentage and reasons, and other reports as needed.
• Adhere to all practice policies related to OSHA, HIPAA and Medicaid Compliance.
• Act as back-up to front desk receptionists when needed.
• Other duties as assigned.
Key Competencies/ Qualifications:
• EMR experience with EPIC
• Proficient in medical terminology, ICD-10 and billing procedures
• Have the ability to manage time effectively
• Exceptional customer service skills
• Strong attention to detail
• Problem solving skills
• Ability to prioritize tasks and work independently
• High School diploma or GED
• 2 years of experience medical billing/coding
• Strong knowledge of Texas Medicaid rules and regulations
AAP/EEO STATEMENT
Bethesda Health Clinic and Hangers of Hope provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, Bethesda Health Clinic and Hangers of Hope complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, and transfer, leaves of absence, compensation and training.
Note: This job description is intended to provide a general overview of the position. It is not an exhaustive list of all responsibilities, qualifications, or working conditions associated with the role. Other job duties and responsibilities may be added, deleted and/or revised at the discretion of management.