Billing Specialist

Job Description: Billing Specialist 

Reports to: Senior Revenue Cycle Manager

Job Purpose:

We are a pediatric non-profit organization seeking a billing specialist to join our professional team. The billing specialist will manage all matters and communications relative to insurance claims on behalf of Texas Hearing Institute.

Position Information:                                                                          

Hours Weekly: 40

Monday – Friday: 8:00 am – 5:00 pm

Starting Salary: Determined by experience.

FLSA Status: Non-exempt

Benefits:

• Health & Dental Insurance
• Life Insurance
• Long Term Disability Insurance
• 403 (b) Retirement Plan
• 12 Paid Holidays
• 21 Paid Time Off Days  

Major Responsibilities

• Stays focused on maximizing revenue and reducing contractual allowances/discounts/MWS and other (grants) write offs at all times
• Files all THI claims.  Files all THI appeals, and corrected claims, as needed
• Handles all communications with Insurance/Medicaid provider relations re: underpayments and/or denials through to final resolution
• Enters and posts all service-related (program) payments into IMS software
• Regularly reviews all client accounts and keeps them clean, including notifying clients of balances due, issuing check requests for refunds due, or making necessary adjusting entries.
• Assists Senior Revenue Cycle Manager in Accounts Receivable (A/R)
• Assists Senior Revenue Cycle Manager with awareness of insurance/Medicaid policy and/or contractual changes, and notifies management and/or program directors as changes occur
• Prepare and process insurance claims timely and accurately to government, commercial and managed care payers.
• Review and distribute corrected claims
• Resolve claim edits via claim edit work queues and/or our external billing software

Other Responsibilities

• Acts as backup to THI Verification Specialist and Front Desk (Receptionist) in their absence and/or as needed

Customer Service Standards

·         Support co-workers and engage in positive interactions.

·         Communicate professionally and timely with internal and external customers

·         Demonstrate friendliness by smiling and making eye contact when greeting all customers.

·         Provide helpful assistance in anticipating and responding to the needs of our customers.

·         Collaborate with customers in planning and decision making to result in optimal solutions.

·         Ability to stay calm under pressure and deal effectively with difficult people

Education and Experience Requirements:

• High school diploma
• Must have three-plus years of claims (insurance billing) experience

Specific Skills:

·         Knowledge and acquired usage of Microsoft standard programs; in particular, Microsoft Word and Excel

·         Good communication skills, particularly with inter-departmental communications

Key Competencies

·         Verbal and written communication skills

·         Professional personal presentation   

·         Standard PC usage

·         Office organization

·         Reliability

Basic Competencies:

·         Internet - using the internet for filing claims, gathering information, and communicating

·         Spreadsheets – knowledge and ability to create, modify, and electronically transmit

·         Email and fax machine knowledge and familiarity

Tools:

·         Desktop computers

·         Laptop computers

·         iPad

·         Scanner

·         Fax machine

·         Copy Machine

·         Postage Meter

Technology:

• Internet
• Microsoft Word and Excel
• IMS (program software) – onsite training

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