HEALTH SERVICES MEDICAL BILLING SPECIALIST
Administration/Billing Program (Classification 706)
SEIU Represented Full Time (37.5 hours/week) position
Responsibilities:
1. Strong working knowledge of CPT, ICD-10, HCPCS, modifiers, coding and documentation guidelines.
2. Input all charges related to services provided by the Health Department into the billing system in accordance with established processes with a strong emphasis on accuracy to ensure efficiency in processing and receipt of payments.
3. Post all payments, by line-item, received for provider’s services into billing system including co-payments, insurance payments, and client payments in accordance with established processes with an emphasis on accuracy to ensure maximum revenue collection.
4. Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills to achieve maximum reimbursement in a timely manner with an emphasis on client satisfaction.
5. Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates.
6. Follow-up on all outstanding client account balances at 60 – 120+ days from the date of service in accordance with practice protocol with an emphasis on maximizing client satisfaction and practice profitability using the A/R aged reports.
7. Process refunds to insurance companies or client in accordance with practice protocol.
8. Provide cross coverage with other team members.
9. Maintain an organized, efficient and professional work environment.
10. Adhere to all practice policies related to OSHA, HIPAA and Medicare and Medicaid Compliance.
11. Assure compliance with Oregon Revised Statutes, Oregon Administrative Rules, related Federal regulations (42 CFR, etc.) and department policies.
12. Utilize collaborative problem-solving and communication skills in a team setting.
Minimum Requirements:
1. Graduation from high school or equivalent GED certificate.
2. Two years of billing experience in healthcare billing or certification in healthcare billing/coding or any satisfactory equivalent combination of education and experience.
3. Typing 60 wpm or better.
4. Excellent computer skills in Microsoft Word, Excel & Access.
5. Possession of a valid Oregon driver's license and good driving record.
6. Ability to pass a criminal history check.
This is a non-supervisory position. Lead work/coordination of work of others is not a typical function assigned to this position. Incumbents in this position may provide training and orientation to newly assigned personnel.
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