What are the responsibilities and job description for the Lead Billing Specialist position at Saint Vincent Physician Services, Inc?
General Summary: Assists with the coordination and supervision of daily activities of a group of Billing Specialist as well as support billing and collections functions of the medical practice.
Essential Job Responsibilities:
1. Adheres to and supports the mission, purpose, philosophy, objectives, policies, and procedures of Tenet Physician Resources.
2. Adheres to the Tenet HIPAA Compliance Plan and the Privacy Standards Confidentiality Agreement.
3. Demonstrates support for the Tenet Corporate Compliance Program by being knowledgeable of compliance responsibilities as expressed in the Code of Conduct; adhering to federal and state laws, rules, regulations, and corporate policies and procedures policies that affect his/her specific job functions/responsibilities; and reporting compliance issues/concerns in a timely and appropriate manner.
4. Provides direction and guidance to less experienced team members.
5. Recognizes and recommends areas needing improvement.
6. Assist in scheduling and coordinating team activities.
7. Handles escalated and unresolved issues from less experienced representatives.
8. Enter charges in a timely manner
9. File claims and run/work audit trails daily
10. Process ERAs, payments, and adjustments
11. Balance daily activity- Prepare and send Batch Cover Sheet to Director and accounting
12. Ensure that front office staff properly collects copays and balances due at time of service by auditing patient financial data up to 2 days before visit
13. Review/work delinquent insurance and patient balances
14. Work credit balances
15. Run reports as requested by management or accounting.
16. Other responsibilities as assigned.
Education: High school diploma/GED required with completion billing or coding program preferred.
Certification: Experience: Must have a minimum of 5 years of experience working in medical billing
Other Requirements: None
Performance Requirements:
Knowledge:
1. Knowledge of Accounts Receivable collection process
2. Knowledge of the Red Flag rules
3. Knowledge of Electronic Health Systems
4. Knowledge of ICD-9 and CPT codes
5. Knowledge of the policies and procedures of the organization to complete billing tasks within compliance of the organization.
