Billing Specialist

Job Description

JOB TITLE: Billing Specialist
SUPERVISED BY: Medical Billing Manager
STATUS: Non-Exempt, Full-Time

Duties and Responsibilities:

The Billing Specialist is responsible for collecting, posting, and managing account payments. Additionally, they are responsible for submitting claims and following up with insurance companies.

Essential Functions:

The functions performed by employees in this job family will vary by level or the area(s) to which assigned but may include (and not be limited to) the following. Employee must perform all duties and responsibilities in accordance with Via Care’s care standards.
- Prepares and submits clean claims to various insurance companies’ either electronically or by paper.
- Answers questions from patients, clerical staff, and insurance companies.
- Identifies and resolves patient billing complaints.
- Prepares, reviews, and sends patient statements.
- Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
- Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency.
- Performs daily backups on office computer system.
- Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
- Processes payments from insurance companies and prepares a daily deposit.
- Participates in educational activities and attends monthly staff meetings.
- Conducts self in accordance with HPA’s employee manual.
- Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Knowledge, Skills, and Abilities:

- Knowledge of medical billing/collection practices.
- Knowledge of computer programs.
- Knowledge of business office procedures.
- Knowledge of basic medical coding and third-party operating procedures and practices.
- Ability to operate a computer and basic office equipment.
- Ability to operate a multi-line telephone system.
- Skill in answering a telephone in a pleasant and helpful manner.
- Ability to read, understand and follow oral and written instructions.

Ability to establish and maintain effective working relationships with patients, employees, and the public.

Must be well organized and detail oriented.

Special Requirements:

- Must have a reliable automobile for use on the job.
- Education: High School Diploma or GED.
- Subject to a criminal background check prior to employment.
- Must possess valid California Driver License.
- Must have and maintain State required automobile insurance coverage.
- TB and post-employment physical clearance, to be renewed every year.

Environmental/Working Conditions:

Normal office environment. Occasional overtime may be required and/or hours may be shortened as business needs dictate. While performing the duties of this Job, the employee is regularly required to sit. The employee is occasionally required to use hands to finger, handle, or feel and talk or hear. The employee must regularly lift and/or move up to 10 pounds and occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.

Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Equal Opportunity Statement:

Via Care Community Health Center provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, gender, sexual orientation, national origin, age, disability, marital status, amnesty, or status as a covered veteran in accordance with applicable federal, state and local laws. Via Care Community Health Center complies with applicable state and local laws governing non-discrimination in employment in every location in which the organization has facilities. This policy applies to all terms and conditions of employment, including, but not limited to, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.