Patient Accounts Billing Specialist

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Time Type:
Full time
Hours per Pay Period:
80
Shift:
As Assigned
Average rate:
$23.97 USD(This represents the rate for an individual with significant experience in this job)
Department:
Patient Accounts
Current Bay Area Hospital Employee: If you are a current Bay Area Hospital employee, please apply through the Workday internal career site.
The future looks bright at Bay Area Hospital, and we are always searching for quality people to join our team. We offer a great atmosphere, competitive pay, a wide array of benefits, and many growth opportunities for our employees.
Job Description:
Patient Accounts Billing Specialist
Responsible for timely and accurate billing of insurance claims for assigned payers, according to regulatory and payer requirements. Resolve billing edits to submit clean claims for all benefit orders. Monitors & resolves Medicare claims in Direct Data Entry (DDE), including claim corrections, claim cancellations and checking claims payment status. Monitors and resolves rejected claims timely. Identifies & reports ongoing charge and/or coding issues. Responsible for claim follow-up as assigned.
SKILLS AND ABILITIES

• Demonstrates working knowledge of American National Standards Institute (ANSI) edits, National Correct Coding Institute (CCI) edits, Medically Unlikely Edits (MUE) and other regulatory and/or payer specific billing requirements
• Demonstrates working knowledge of 837i and 837p claim formats, as well as UB04 and 1500 professional billing requirements
• Familiar with CPT, HCPCS, revenue codes and ICD-10 coding requirements
• Demonstrates understanding of payer credentialing requirements
• Organizational skills that promote the ability to work well without direct supervision, manage time effectively and appropriately prioritize multiple assignments to meet project timelines.
• Effective collaboration and communication with a variety of individuals, both internal and external, including multidisciplinary teams.
• Ensures recommendations support adherence to all federal, state and other regulatory requirements.
• Demonstrates the ability to analyze and solve complex system problems, and ability to prioritize, manage and implement complex projects
• Effective and professional communication skills, both in verbal and written
• Exhibits the ability to maintain confidentiality, think and act independently with minimal supervision
• Ability to use initiative and judgment skills in carrying out responsibilities
• Flexibility in job schedule to provide user support and advance project goals.
• Maintain regular, consistent and punctual attendance at the assigned job location
• Demonstrates the ability to use a personal computer, office equipment and various software programs applicable to the position

EDUCATION/CERTIFICATIONS/LICENSES/DEGREES

• High School graduate or equivalent preferred
• Associates or Bachelor's degree preferred
• Healthcare, customer service, change management, project management or process improvement certifications preferred

EXPERIENCE

• Minimum of one year of experience in medical business office
• Minimal knowledge of hospital and collection process in hospital and/or medical office setting
• Experience with EPIC, Soarian, EDM,MS4, ADT, claims, MIRA DSG, SSI, Experian, Craneware or other revenue cycle billing experience preferred
• Experience with 837i and or 837p and HIPAA transaction sets such as CPT,HCPCS, revenue codes, ICD9 and ICD10, CARC (Claim Adjustment Reason Code) or CAS (Claim Adjustment Segment) codes preferred
• Experience in Excel, Word and Power Point preferred

GENERAL INFORMATION
Union Affiliation: UFCW
The above statements are intended to describe the general nature and level of work being performed by individuals assigned to this position. They are not intended to be an exhaustive list of all duties, responsibilities and job skills required.
Physical/Mental/Environmental Requirements

• Requires extensive sitting with periodic standing and walking
• May be required to lift up to 20 pounds
• Requires significant use of personal computer, phone and general office equipment
• Needs adequate visual acuity, ability to grasp and handle objects
• Needs ability to communicate effectively through reading, writing and speaking in person or telephone
• May require off-site travel

Compensation Grade:
UFCW
Compensation Grade Profile:
U044
Bay Area Hospital is an Equal Opportunity Employer.
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