Medical Billing Specialist-Pittsburg, KS


POSITION: Medical Billing Specialist

DEPARTMENT: Revenue Cycle

REPORTS TO:  Director of Revenue Cycle

DIRECT REPORTS: None

FLSA STATUS: Non-Exempt

CORE VALUES

The core values of Community Health Center of Southeast Kansas, Inc. (CHC/SEK) are dignity and stewardship.  Each staff member is expected to perform their job duties in a way that preserves dignity for our patients and maintains good stewardship of CHC/SEK’s resources.

GENERAL DESCRIPTION

This position is part of the revenue cycle team. This position is responsible for entering data necessary for the collection of revenues from third party payers, as well as individual patients. This position may be the first interaction that patients have with Community Health and practices should not create barriers to obtaining care or information. This position requires significant time interacting with patients, payers, public on the phone, as such, excellent communication skills are required.

ESSENTIAL DUTIES

  1. Review data entered into the Electronic Health Record for accuracy and completeness.
  2. Verify/input diagnosis/procedure codes necessary for accurate billing of all charges for services.
  3. Prepare and submit billing data and medical claims to insurance companies for reimbursement.
  4. Knowledge of billing requirements for all payers and Federally Qualified Health Center guidelines for Medicare and Medicaid.
  5. Timely A/R follow up on denied claims with an effort to ensure reimbursement.
  6. Review of patient/insurance credits and processing of refunds.
  7. Ability to respectfully communicate accurate information to patients regarding outstanding balance both on the phone and in person.
  8. Assist with patient payment plans and posting of payments and adjustments.
  9. Knowledge of financial assistance and sliding fee scales for all specialties.
  10. Prepare invoices required for special programs reimbursed under separate contracts with CHCSEK.
  11. Knowledge of primary code classifications: ICD-10-CM, CPT, CDT, HCPCS
  12. Build and maintain positive, supportive working relationships with clients, patients, providers, community organizations, and others.
  13. Perform other duties as assigned.

QUALIFICATIONS

  1. High school diploma or equivalent required.
  2. CPB (Certified Professional Biller), or willingness to become one within 6 months after date of hire.
  3. Minimum of one year of experience working in a healthcare related field.
  4. Any combination of education and work experience that would likely provide the required knowledge and abilities is qualifying.

KNOWLEDGE, SKILLS AND ABILITIES

  1. Social and cultural sensitivity appropriate to ethnically and economically diverse patient-and employee-base.
  2. Demonstrate knowledge of the rationale of appropriate patient care.
  3. Must be organized and able to manage/prioritize tasks to meet deadlines, adapts to change in a positive manner, able to work as a part of a team.
  4. Communicates through appropriate channels. Use proper chain of command for patient complaints.
  5. Ability to handle emergency situations calmly and effectively.
  6. Must be computer literate, especially with Microsoft Office products and be proficient with the Electronic Health Record software.
  7. Must be able to maintain good inter-personal relationship with co-workers and other members of the health care team and the organization.
  8. Provide customer service in accordance to the organization’s mission.
  9. Be courteous and respectful when interacting with patients and family members.
  10. Maintain patient confidentiality in accordance to organization’s policy and procedure and HIPAA requirements.
  11. Strong accounting professional.

WORKING CONDITIONS

While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reach with hands and arms and talk or hear. The employee is occasionally required to stand and walk.  The employee must regularly lift and /or move up to 10 pounds.  Specific vision abilities required by this job include close vision, color vision, peripheral vision, depth perception and ability to adjust focus. Travel is required throughout the service area.