What are the responsibilities and job description for the Medical Billing Specialist position at Carroll County Memorial Hospital?
Position Summary
The medical billing specialist is responsible for ensuring accurate billing, timely submission of electronic and/or paper claims, monitoring claim status, researching rejections and denials and documenting related account activities. The medical billing specialist must possess critical thinking skills and understanding of Medicare, Medicaid eligibility requirements as well as commercial insurance payer payment methods. In addition, the medical billing specialist must demonstrate proficiency with billing system to ensure all functionality is utilized for the utmost efficient processing of claims.
Essential Functions and Responsibilities
Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment in a manner consistent with the hospital’s mission, vision, and ICARE values.
Contacts payers for medical claims status, follow-up on denials.
Responsible for correcting, completing, and processing claims for all payer codes.
Researches credit balances and initiates refunds as required.
Analyze and interpret that claims are accurately sent to insurance companies.
Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
Process appeals online or via paper submission.
Communicate with Patient Accounting Director to identify and resolve audit review issues.
Maintain patient confidence and protects medical office operations by keeping patient information confidential.
Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment.
Monitor and evaluate processes and workflows; provides recommendations to optimize performance/outcomes; works with clinic team and hospital leadership to implement recommended strategies.
Maintains regular, predictable attendance according to hospital policy.
Other duties as assigned.
Education/Experience
High School Diploma equivalent required
Associate Degree preferred
Medical Billing and Coding Certificate Preferred
Ability to foster a positive team atmosphere through effective interpersonal skills
Able to effectively communicate both verbal and written format
Strong analytical, problem-solving, and organizational skills
Ability to use multiple electronic systems, software, internet, and computer skills
Note
This job description in no way states or implies that these are the only duties to be performed by the employee(s) in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.
Carroll County Memorial Hospital is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.