Billing Specialist

At CCHS, our goal is to grant equal access to healthcare no matter the economic, social or employment status of our patients. We aim to provide superior patient care! If you have a passion for helping people, for mission work and would like to combine that passion with your clinical skills, this may be the position for you. We offer competitive pay, great benefits with a culture to match.

POSITION SUMMARY

The Billing Specialist is responsible for pursuing and receiving all monies due from insurance companies and patients. The incumbent is also responsible for corresponding with CCHS' third-party billing company and managing accounts receivable for various payers and service areas. Primary resource for PPS reconciliation and submission to state.

KEY RESPONSIBILITIES

• PPS reconciliation and submission.

• Creates encounters and submits claims to insurance.

• Enters patient demographics, verifies insurance and reviews accounts for accuracy.

• Collects, posts, and manages account payments from insurance companies, public grant funded programs/service agreements and patients.

• Corresponds with third-party billing company to ensure timely follow-up of requested information (i.e. returns, refunds, recoupments, submission of hospital encounters, patient complaints, coding and fee inquiries, etc.)

• Manages accounts receivable for assigned service areas and payers.

• Develops payment plans as needed.

• Assists with fee schedule management as directed.

• Corresponds with Site Managers, providers and pharmacy staff regarding billing errors, information requests, returns, questions, etc.

• Monitors assigned health center work lists to ensure all encounters are created and billed.

• Handles mail and distributes accordingly.

• Communicates as needed with insurance companies.

• Assists with establishment of CDT codes and entry of NDC numbers as assigned.

• Assists with review of denial data and identifies training needs of providers, clinical staff and front office staff.

• Works with Accounting Department as necessary.

• Investigates insurance fraud and reports if found.

• Meets established deadlines.

• Performs other duties as assigned.

POSITION REQUIREMENTS

Education: High school diploma plus some specialized training.

Experience: Four to six years of related experience; previous experience working an aging report; intermediate to advanced Excel skills