Billing Specialist

Lifestream Behavioral Center

Leesburg , FL 34748

JOB TITLE: Billing Specialist - Inpatient DATE PREPARED: 01/27/1997

DEPARTMENT: Billing Support Dept 003 DATE REVISED: 02/24/2015

POSITION REPORTS TO: Billing Office Supervisor

JOB SUMMARY: Responsible for billing all inpatient charges for all insurances. Responsible for auditing accounts after payments and doing write-off sheets. Reviews payment and prepared adjustments.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES: The list of essential functions, as outlined herein, is intended to be representative of the tasks performed within this classification. It is not necessarily descriptive of any one position in the class. The omission of an essential function does not preclude management from assigning duties not listed herein if such functions are a logical assignment to the position.

  • Bill inpatient charges to assigned company and follow up with denied claims

  • 60 day report, EOBs in a timely manner using EASE as a tool for Medicare A claims

  • Review EOBs for accuracy of payments and postings

  • File appeals and follow-up if not responded in a timely manner

  • Request medical records for appeals/claims/insurance company inquiries

  • Review unpaid claim files every 30 days

  • Insurance paid letters to in-patient consumers

  • Answer consumer calls/return voice messages

  • Bill WIN clinic claims and closely work with consultant on medical billing questions and issues

  • Work closely with WIN staff; superbill, document notes, ICD-9 codes

  • Continue medical billing training/education to ensure accurate billing

  • Ability to perform other duties as assigned

KNOWLEDGE AND JOB SKILLS: Data Entry, Microsoft Word and Excel, Common computer skills, Knowledge of office equipment business math and typing.

CORE COMPETENCIES:

  1. Basic Job Readiness: Courtesy, flexibility, reliability, responsiveness
  2. Personal Effectiveness: Communications, Interpersonal Skills, Self-Management, Thinking Skills
  3. Organizational/Management: Compliance, CQI Commitment, Management of information, Organizational participation, safety
  4. Performance Specific: Crisis management, customer focus

JUDGMENT: Good judgment is integral to security, confidentiality and satisfactory work.

JOB REQUIREMENTS:

Education: High School diploma required.

Experience: One year experience in an office setting and one year computer experience required. Billing experience in a mental health setting preferred.

Personal Qualities: Ability and willingness to learn, initiative.

Special Factors: Maintains a professional atmosphere. Provides excellent customer service, good working relationship with employer, as well as, facility staff and external agencies. Regular communication with insurance companies.

Supervisory Responsibilities:
N/A

Staff Development: Completes all requirements according to Individual Training Plan within the first six months of hire and annually.

POSITION CONTENT: This job description is not intended to be and should not be construed as an all inclusive list of all the responsibilities, skills or working conditions associated with the position. While it is intended to accurately reflect the position activities and requirements, Management reserves the right to modify, and/or remove duties and assign other duties as necessary.


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Billing Specialist

Lifestream Behavioral Center