PURPOSEThe Billing Specialist is a member of the Billing Team and is responsible for coordinating the billing of claims received from the facility on timely fashion.DUTIESThe duties of this position are those described below.
This job description does not state or imply that the duties listed are the only duties and responsibilities assigned to this position.
Employees holding this position will be required to perform any other job-related duties as requested by management.Submits reimbursement claims to third parties (insurance health plans, government agencies, etc) for services rendered for their patientsEnsures claims have the required information in the specified format.
Reviews claims for errors prior to submission.Submits claims within the required timeframes to ensure consistent cash flow and reduce risk of technical denials for untimely filing.Follows up on claims to ensure third party or government agency received the claim:Electronic billing verification no less than 48-hours after claim submissionValidates supporting documentation prior to submitting the claim including but not limited to balanced census, authorization, etc.Reviews aging no less than monthly and identifies unpaid accounts.
Completes follow-up on all unpaid accounts monthly especially for the assigned accountsNotifies facility of cash posting and revenue errors and makes recommendations for correction.Responds to requests from various departments and facility staff.Responds to collection and audit requests timely.Other duties as assignedEDUCATION REQUIREMENTSHigh school diploma or equivalent, college level a plusEXPERIENCE REQUIRMENTSMinimum of 3 years in Healthcare, preferably Durable Medical Equipment (DME)Minimum 2 years of relevant medical billing, AR Collections and claims management experienceExcellent communication, interpersonal, and prioritization skillsStrong telephone skills and handling customer complaintsStrong prioritizing, time management and organization skillsAbility to perform basic mathematical calculationsAbility to work independently with minimal guidanceStrong analytical, problem solving and decision-making skillsAbility to act with urgency, ownership and follow-throughHigh degree of accuracy and attention to detailProfessional and disciplined work habits (time & attendance, following company policies, strong work ethics, etc.)Must be able to read, write, speak, and understand the English languageCompetency using office equipment and operating technology systemsEQUIPMENT USEDPC, Calculator, Office Copying, FAX and Scanning MachineCOMPUTER SKILLS AND APPLICATIONSGood proficiency in Microsoft Office Suite (Word, Excel) familiarity with PowerPoint, Outlook; ability to use the Internet for research and information in support of job duties.PHYSICAL DEMANDS (All requirements are subject to possible modification to reasonably accommodate individuals with a disability)The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.While performing the duties of this job, the employee may be required to sit, stand, stoop, bend and walk intermittently during the day.
May be necessary to work extended hours as needed.
The employee is occasionally required to climb, balance, stoop, kneel, crouch, crawl; talk or hear; taste or smell; use hands to finger, handle, or feel; and reach with hands and arms.
Finger dexterity to operate office equipment is required.
May need to lift up to fifty (50) pounds on occasion.
Visual acuity to see and read fine prints.
Specific vision abilities required by this role include close vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.Mini Pharmacy is an equal opportunity employer, dedicated to promoting a culturally diverse workforce.
All qualified applicants will receive consideration for employment without regards to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.City of Los Angeles’ Fair Chance Initiative:We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable state and local laws, including the City of Los Angeles’ Fair Chance Initiative for Hiring Ordinance.