[Hiring] Site Billing Specialist @Healthcare Outcomes Performance Company

Role Description

As HOPCo continues to grow, we are looking for a Site Billing Specialist. Please see below for the functions and requirements for this position.

Essential Functions

• Maintains productivity and accuracy metrics per department expectation and AEIOU Behavioral Standards.
• Abstracts data from medical records to ensure proper coding of diagnosis and procedures including any applicable modifiers.
• Reviews insurance denials and rejections to determine next appropriate action steps and obtain necessary information to resolve any outstanding denials/rejections.
• Updates and confirms as necessary to allow processing of claims to insurance plans.
• Researches all information needed to complete billing process including obtaining information from providers, ancillary services staff and patients.
• Attaches referrals/authorizations to appointments/charges if available.
• Maintains satisfactory productivity rates and ensures the timeliness of claims reimbursement while maintaining work queue goals.
• Makes and receives calls to/from patients to collect on self-pay balances and any other outstanding balance.
• Counsels patients face to face when patients have questions or concerns regarding outstanding balances.
• Acts as a resource to staff and providers including providing subject matter expert education on billing and coding guidelines.
• Completes daily requests and works through obstacles on account balance to ensure maximum reimbursement.
• Identifies and communicates trends and/or potential issues to management team.
• Follows and maintains all CORE Institute policies and procedures, including those specific to billing and the Business Office.
• Other duties as assigned by leadership.

Qualifications

• High school diploma/GED or equivalent working knowledge preferred.
• Minimum two to three years of billing experience in a physician practice.
• Must be able to communicate effectively with physicians, patients and the public and be capable of establishing good working relationships with both internal and external customers.
• Prefer prior coding experience with CPC, CCS, RHIT or RHIA Certification.

Requirements

• Knowledge of government provisions and billing guidelines.
• Advanced computer knowledge, including Windows based programs.
• Skilled in defusing difficult situations and able to be consistently pleasant and helpful.
• Skill in using computer programs and applications.
• Skill in establishing good working relationships with both internal and external customers.
• Ability to multi-task in a fast-paced environment. Must be detail-oriented with strong organizational skills.
• Ability to understand patient demographic information and determine insurance eligibility.
• Ability to work independently and demonstrate the ability to analyze data.
• Ability to type a minimum of 45 wpm.

Environmental Working Conditions

• Normal office environment.

Physical/Mental Demands

• Requires sitting and standing associated with a normal office environment.
• Combination of bending, lifting and transferring activities.
• Manual dexterity using a calculator and computer keyboard.

Organizational Requirements

• HOPCo Mission, Vision and Values must be read and signed.