Business Svcs Rep II, Prof Billing/Collections

Job Summary:

Under the direct supervision of the Manager, the Billing/Collections representative is responsible for the billing and collecting of all professional claims, in accordance with state and federal regulations and HMNH policies. Compiles and maintains records for services rendered and ensures accurate entries; assists in processing claims for timely reimbursement.

Licensure and Certification:

• N/A

Education:

• Minimum High School graduate or GED equivalent

Experience:

• 3 year minimum experience with professional billing in a hospital, medical, and/or health care environment.

Knowledge and Skills:

• Computer experience mandatory.

• Knowledge of all third party reimbursement issues and/or updates related to billing government, and commercial claims

• Knowledge of medical terminology, CPT, ICD10

• Competent in billing compliance.

• Ability to accept and adapt to change easily.

• Ability to communicate verbally and in writing, to be a self-starter, and demonstrate a pleasant voice and good public relations while performing duties.

• HMO/PPO knowledge required.

Physical Demands - Clerical/Administrative Non-Patient Care:

• Frequent sitting and standing/walking with frequent position change.

• Continuous use of bilateral upper extremities in fine motor activities requiring fingering, grasping, and forward reaching between waist and chest level.

• Occasional/intermittent reaching at or above shoulder level.

• Occasional/intermittent bending, squatting, kneeling, pushing/pulling, twisting, and climbing.

• Occasional/intermittent lifting and carrying objects/equipment weighing up to 25 pounds.

• Continuous use of near vision, hearing and verbal communication skills in handling telephone calls, interacting with customers and co-workers and performing job duties.

Key for Physical Demands

Continuous

66 to 100% of the time

Frequent

33 to 65% of the time

Occasional

0 to 32% of the time