[Hiring] Clinic Billing Specialist III @Baton Rouge General - Bluebonnet

Role Description

To review and prepare billing forms and ensure accuracy and completeness for electronic or hardcopy claims submission.

Performance Criteria

• Everyday Excellence Values
  • Demonstrates courtesy and caring to each other, patients and their families, physicians, and the community.
  • Takes initiative in living our Everyday Excellence values and vital signs.
  • Takes initiative in identifying customer needs before the customer asks.
  • Participates in teamwork willingly and with enthusiasm.
  • Demonstrates respect for the dignity and privacy needs of customers through personal action and attention to the environment of care.
  • Keeps customers informed, answers customer questions and anticipates information needs of customers.
• Corporate Compliance
  • Practices diligence in fulfilling the regulatory and legal requirements of the position and department.
  • Maintains accurate and reliable patient/organizational records.
  • Maintains professional relationships with appropriate officials; communicates honestly and completely; behaves in a fair and nondiscriminatory manner in all professional contacts.
• Personal Achievement
  • Uses accepted procedures and practices to complete assignments. Uses creative and proactive solutions to achieve objectives even when workload and demands are high.
  • Adheres to high moral principles of honesty, loyalty, sincerity, and fairness.
  • Upholds the ethical standards of the organization.
• Performance Improvement
  • Optimizes talents, skills, and abilities in achieving excellence in meeting and exceeding customer expectations.
  • Initiates or redesigns to continuously improve work processes.
  • Contributes ideas and suggestions to improve approaches to work processes.
  • Willingly participates in organization and/or department quality initiatives.
• Cost Management
  • Effectively manages time and resources.
  • Makes conscious effort to effectively utilize the resources of the organization - material, human, and financial.
  • Consistently looks for and uses resource saving processes.
• Patient & Employee Safety
  • Effectively communicates, demonstrates, coordinates and emphasizes patient and employee safety.
  • Proactively reports errors, potential errors, injuries or potential injuries.
  • Demonstrates departmental specific patient and employee safety standards at all times.
  • Demonstrates the use of proper safety techniques, equipment and devices and follows safety policies, procedures and plans.

Job Functions

• Essential Job Functions
  • Prepares and reviews all billing forms to ensure accuracy and completeness for claims submission to insurance carriers.
    • Identifies and records required billing information according to insurance carrier requirements with 100% accuracy.
    • Completes billing information accurately.
    • Processes claims electronically with 100% accuracy and mails claims to insurance carriers daily.
  • Enters documentation and adjustments through computer system to maintain a correct account balance.
    • Updates system information daily according to correspondence received and processed.
    • Documents any changes on a daily basis and submits information to appropriate personnel.
    • Seeks clear directions to resolve issues and bring problems to a proper resolution.
  • Reviews and identifies charge discrepancies and completes all requests for rebilling from inter-department personnel.
    • Reviews charge summaries on each patient bill that is produced and identifies discrepancies with 100% accuracy.
    • Audits requests for accurate information.
    • Completes rebilling within 10 days according to established rebilling procedures.
    • Manually documents rebilling log upon completion with 100% accuracy.
  • Prepares daily production reports, maintains required records, reports, and files while evaluating account information.
    • Monitors number of accounts and outstanding balances within three days of receiving report.
    • Consistently applies appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
    • Initiates appropriate follow-up.
  • Performs all other duties as assigned.

Specific Experience Requirements

• Prior experience with general office responsibilities.

Specific Educational Requirements

• High School Diploma preferred.

Special Skill, License and Knowledge Requirements

• Minimum typing skills of 45 wpm, ten key by touch, data entry skills.

HIPAA Requirements

• Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position.

Safety Requirements

• Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, handling wastes, sharps and linens, PPE, exposure control plan, hand washing, and environmental round to ensure safety.