Billing Associate

JOB SUMMARY: The Billing Associate is responsible to work closely with other members of the business office in order to facilitate timely and accurate billing of medical and dental claims. This position reports directly to the Revenue Cycle Coordinator.

SPECTRA HEALTH EXPECTATIONS

• Review and comply with regulatory standards
• Strict adherence for privacy and confidentiality, for both patients and employees of Spectra Health
• Champion Spectra Health's organizational values of Compassion, Trust, Respect, Equity, and Inclusivity.
• Affirm Spectra Health's culture of safety by demonstrating actions and behaviors that consistently contribute to a positive and safe work environment for our employees and guests. (i.e., timely incident reporting, resolving hazards proactively, resolving privacy and security concerns, etc.).
• A positive approach to teamwork, building collaborative positive relationships throughout the organization in order to share knowledge and experience.
• Ability to work independently.
• Be part of the solution, supporting change and participating in activities to promote organizational leadership.
• Make decisions based on what's best for Spectra Health's patients.
• Attend mandatory trainings and attend at least 80% of departmental meetings.
• Adhere to all Spectra Health's policies and procedures and serves as a departmental champion of Spectra Health's Compliance Program activities.

ESSENTIAL JOB FUNCTIONS:

• Ensure all previous day encounters have been coded & post daily charges.
• Retrieve and reconcile daily claim submission.
• Monitor unposted claims.
• Maintain fee schedule in the billing software.
• Maintain insurance plan table in the billing software.
• Complete Worker's Comp and insurance claims.
• Monitor accounts for payments and denials.
• Identify claims which cannot be transmitted and request paper claims from the system and edits, corrects and batches forms for mailing and/or electronic transmission.
• Communicate billing updates or changes to appropriate staff.
• Ensure transfer of claims to appropriate clearinghouses.
• Obtains Medicare Secondary Payer information as needed.
• Optimizes cash returns and minimizes denied charges.
• Works with team to research and resolve all claims in a Reject or Error status.
• Print insurance claims as needed
• Assists with the processing of incoming and outgoing mail.
• Assists with preparing monthly closing reports and submit them to the CFO.
• Assists with preparing a monthly electronic statement file and FTP to outside vendors.
• Responds appropriately to necessary changes by staying up to date on payer requirements and system capabilities through insurance bulletins and by working and editing accounts.
• Answer patient inquiries and handle patient correspondence as they pertain to billing issues.
• Remains sensitive, yet assertive when assisting patients.
• Work closely and in conjunction with other business office staff
• Perform other duties as assigned.

JOB QUALIFICATIONS:

Required:

• A high school diploma.
• Experience in healthcare billing.
• Excellent oral and written communication skills.
• Knowledge of CPT and ICD 9/10 codes.
• Working knowledge of Federal billing regulations and other insurers requirements.
• Technically proficient computer skills.
• Thorough knowledge of common office equipment (i.e. copier, printer, fax, etc.).
• In-depth knowledge of Microsoft Office Suite.
• Ability to gain proficiency in Spectra Health's organizational software programs.
• Ability to organize and prioritize tasks.
• Ability to work under pressure and meet deadlines.
• Strong analytical, attention to detail, and problem-solving skills.
• Ability to work independently and as a member of a team.

Preferred:

• A Bachelor's degree in Medical Billing.
• Experience working with Medicare and Medicaid billing.

PHYSICAL REQUIREMENTS: The Billing Associate is primarily a desk job that requires the ability to sit for long periods of time (up to 8 hours) at a desk or workstation. Periodically, the position requires lifting or carrying items that would be appropriate in an office environment, not more than 20lbs.

REMOTE WORK: The Billing Associate position is eligible for full-time or hybrid remote work. For more information about remote work, please see HR Policy 1.29 - Remote Work.

**Spectra Health provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, genetics, sexual orientation or gender identity.

Salary : $17 - $19