Medical Billing Specialist (Experienced Medical Billing)

Full-and Part-Time Employee Benefits

Medical, Dental, and Vision Insurance Cancer plan.

401(k) retirement plan with matching Accident plan.

Paid time off (PTO) program Critical life events plan.

Tuition and certification reimbursement Employee Assistance Program (EAP).

Group Term Life Insurance and AD&D Free parking at all locations.

Short term and Long term disability Mileage reimbursement for company travel.

Un-reimbursed medical and dependent care.

POSITION SUMMARY

The Medical Billing Specialist is responsible for all payors (Medicare, Patient Pay, Medicare Secondary Payor, and Commercial Insurance) as assigned. This position will be familiar with all of the provider numbers.

QUALIFICATIONS

Education: High school diploma or GED.

Experience: Minimum of one-year medical billing experience preferred; proficiency with a variety of computer software programs.

Additional Requirements: May be required to work flexible hours and occasional overtime.

PRIMARY RESPONSIBILITIES

Verify eligibility within a timely manner.
Moves claims to Medicare Secondary Payor claims weekly and alerts the Billing Company so they can submit the claim.
Follows the process for patient pay; which consists of contacting social workers to work with patient/families and processing the Financial Assistance Applications. Will process and send monthly statements, check to see if any patient pay accounts can be billed to probate, follow up on any outstanding patient pay accounts per Arkansas Hospice Policy, etc.
Works with the Billing Company to ensure follow up and issues are resolved quickly.
Backs up the Medical Billing Specialist—NH, may be assigned a provider number to process and maintain up to date processes and access
Follow any changes to a patient’s account on a daily basis by reviewing and completing workflow. Also, reviews Coordination Notes and completes Administrative Tasks in the Electronic Medical Record (EMR).
Follows up bi-weekly on all assigned patient accounts over 30 days old and will document in the EMR and coordinate with the billing company on the information as to why the claims have not processed for payment. Follow up on accounts in accordance with Finance Department guidelines.
Runs an admission report daily for Medicaid patients to ascertain PCP referrals if applicable.
Posts cash into EMR for all payments and adjustments received on patient accounts and move the remaining balance to self-pay or secondary insurance.
Prepares invoices for nursing home room & board charges on a weekly basis and bills all Nursing Home claims to MCD every Friday.
Coordinates with the nursing home staff to obtain the required paperwork (703/704) needed to get the claims billed.
Semi-annually works with the facilities to get updated rate letters and reconciles those to the RAs to ensure proper payment is being processed by Medicaid.
Sends out denial letters weekly for patient related invoices that are denied by Arkansas Hospice.
Communicates with physicians’ offices, hospitals, insurance companies, and other providers to obtain required information on patient billing sources.
Takes call for the Finance Department on a rotating schedule to verify patient’s eligibility, Medicare benefit period, and notification of Face-to-Face visit if applicable, coordinate with the admission staff, and document in the EMR.
Verify physician visits with Health Information Management.
Assists the Controller and the Medical Billing Supervisor as requested; assists with other office functions as required.
Handles confidential material with tact, diplomacy and discretion.
Maintains strict confidentiality at all times.
Utilizes and models excellent customer service skills at all times; seeks opportunities to assist patients, families and co-workers; demonstrates teamwork and cooperation.
Accepts direction and follows instructions from supervisor; seeks additional information as needed; works with minimal supervision.
Adheres to all organizational and departmental policies and procedures.
Continually meets organizational standards for attendance and punctuality; notifies supervisor in a timely manner when employee will be absent or late for work.
Attends all required meetings and in-services; seeks opportunities for additional professional development activities as appropriate.

COMPETENCIES, KNOWLEDGE, SKILLS, AND ABILITIES

THIS SECTION DESCRIBES WHAT KNOWLEDGE, SKILLS AND ABILITIES AN EMPLOYEE IN THIS POSITION SHOULD CURRENTLY POSSESS. THIS LIST MAY NOT BE COMPLETE FOR ALL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED FOR THIS POSITION.

Ability to communicate effectively both orally and in writing.
Ability to communicate effectively with co-workers and other customers.
Ability to follow basic safety policies and procedures.
Ability to use good judgment and to maintain confidentiality of information.
Ability to work as a team player.
Ability to demonstrate tact, resourcefulness, patience and dedication.
Ability to accept direction and adhere to policies and procedures.
Ability to work in a fast-paced environment.

Performs the above listed functions while regularly working with confidential and/or proprietary Arkansas Hospice and patient information, including but not limited to patient medical records, current or former employee information, Arkansas Hospice records, and other information that the employee regularly uses to perform job functions.

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