BILLING SPECIALIST

Description

The Billing Specialist ensures compliance of philosophy, policies, procedures, and goals of the Clara Barton Hospital. The Billing Specialist will be cross-trained to be able to perform work in patient billing for claims processing and collections. ESSENTIAL FUNCTIONS: The billing specialist will review the claim to verify the information appears to be accurate on the claim. If there are questions, a contact will be made to the Director of the ancillary department. When needed the biller will be accessing the electric medical record to verify the documentation reflects the charges on the claim. Prepare claims to submit to both primary and secondary insurance companies for payment on patient accounts Transmits claims electronically to Medicare, Medicaid, Blue Cross and all other Commerical carriers daily Contacts insurance companies to resolve claims that have not timely made payment. Call patient if needing to verify insurance information. Posting the remittance advice payment and verifying that the payment was posted correctly. Resubmit information required by insurance companies in order to process claims for payment Make adjustments to the computer classification of claims to most accurately reflect the expected pay source Meets monthly cash collection/AR day goals. Attends annual in-services and updates staff development records accordingly Attends ACE meetings as they apply to job and/or mandatory CBH meetings as needed Responsible to resubmit unpaid claims on aging reports and work to meet the department aging goals Processes accuracy of insurance payments Performs other tasks as may be assigned

Required Knowledge, Skills, Abilities, Education, or Experience

Knowledge of basic bookkeeping, general accounting, collecting, and standard office practices and procedures. Ability to type. Graduation from High School or equivalent. Ability to use Internet and process claims through the hospital system.