BILLING SPECIALIST II

Job Summary

Manages account receivables by preparing and submitting claims to insurance carriers, posting insurance and patient payments, performing follow up with insurance carriers on unpaid, rejected or denied claims and answering patient inquiries on account status and charges.

Job Responsibilities

• Enters information necessary for insurance claims such as patient information, insurance identification, diagnosis and treatment codes, modifiers, and provider information.
• Ensures claim information is complete and accurate.
• Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper.
• Follows up with insurance companies for unpaid or rejected claims.
• Communicates with payors and other necessary contacts to resolve issue and re-submit claims as needed.
• Prepares appeal letters to insurance carrier when not in agreement with claim denial.
• Collects necessary information to accompany appeal.
• Prepares and submits secondary claims upon processing by primary insurer.
• Posts insurance and patient payments via electronic remit posting or manual posting.
• Answers patients' questions on patient responsible portions, co-pays, deductibles, write-offs, etc.
• Resolves patient complaints or explains why certain services are not covered.
• Prepares and reviews routine billing reports to ensure timely and accurate billing activity.
• Recommends process improvements based on findings.

Qualifications

• High school diploma, General Equivalency Diploma (GED) or higher required upon hire
• A minimum of 2 years' relevant experience required
• No licensure/certification/registration required

Skills and Attributes

• Requires critical thinking skills and decisive judgment.
• Works under general supervision.
• Must be able to work in a stressful environment and take appropriate action.
• Applies more advanced skills and knowledge in the area of specialization.

Physical Demands

• Standing: Occasionally
• Walking: Occasionally
• Sitting: Frequently
• Lifting 0-25 lbs: Rarely
• Lifting 25-75 lbs: Never
• Lifting over 75 lbs: Never
• Carrying 0-25 lbs: Rarely
• Carrying 25-75 lbs: Never
• Carrying over 75 lbs: Never
• Pushing/Pulling 0-25 lbs: Rarely
• Pushing/Pulling 25-75 lbs: Never
• Pushing/Pulling over 75 lbs: Never
• Climbing: Rarely
• Bending/Stooping: Rarely
• Kneeling: Rarely
• Crouching/Crawling: Rarely
• Reaching: Occasionally
• Talking: Frequently
• Hearing: Occasionally
• Repetitive Foot/Leg Movements: Never
• Repetitive Hand/Arm Movements: Frequently
• Keyboard Data Entry: Frequently
• Running: Never
• Vision: Depth Perception: Frequently
• Vision: Distinguish Color: Frequently
• Vision: Seeing Far: Frequently
• Vision: Seeing Near: Frequently

Owensboro Health Core Commitments

INTEGRITY - We conduct ourselves with a high level of responsibility, reliability and honesty because we take seriously the trust of our patients and coworkers.

RESPECT - We value and accept the unique talents and contributions of every patient, customer and team member in the Owensboro Health community.

TEAMWORK - We build a spirit of connectivity and fellowship by striving together to overcome obstacles, surpass goals, celebrate accomplishments and plan the future.

INNOVATION - We foster original ideas and creative solutions that improve our daily work and promote the mission of Owensboro Health.

SERVICE - We focus on service to patients, customers and team members by anticipating their needs, thoughtfully meeting those needs and continually improving the quality of everything we do.

EXCELLENCE - We reach beyond basic expectations to expand our knowledge and awareness, produce exceptional work and provide outstanding service.