Medical Billing Specialist (Part-Time)

Overview

Join the Public Health Agency as a part-time Medical Billing Specialist, where we’re seeking a candidate who embodies initiative, independence, and expertise. With a system that demands proactive problem-solving and critical thinking, we’re looking for a self-starter who can navigate complexities with ease. Extensive experience with various coding sets, including a strong command of medical ICD-10 codes, CPT medical billing codes, and full revenue cycle management is essential.

Excellent communication skills are paramount for interactions with patients, insurance companies, and stakeholders. Our ideal candidate exhibits robust problem-solving and decision-making abilities, capable of managing multiple tasks and deadlines in a fast-paced environment.

In this role, you’ll provide support throughout the billing and payment process, manually generate patient statements, and meticulously apply payments to accounts. Regular system auditing will require critical thinking and problem-solving to maintain accuracy and resolve discrepancies. If you’re ready to make a meaningful impact and excel in a dynamic environment, we encourage you to apply TODAY!!!

Hiring Rate: $20.00 – $23.00 (commensurate with qualifications)
This is an in-person position and is not eligible for remote work. This position does not include benefits. This position has an anticipated work schedule of Monday, Wednesday, Friday (Flexible) 8:00am – 4:30pm, subject to change. Under FLSA guidelines, this position is non-exempt.

Please be advised this position may close on or after 12/05/2024, without advance notice, should we receive a sufficient number of qualified applications

Collects and enters medical claim information into electronic health record system modules. Follows up with insurance companies and patients to ensure correct and accurate payment of services. Tracks managed care authorizations and limits of coverage. Ensures provider and insurance credentialing is accurate and up to date.

Essential Duties/Responsibilities
Assists with enrolling new clients and verifying insurance coverage.
Obtains necessary pre-authorizations and ensures proper documentation and filing of authorizations.
Utilizes ICD 10 diagnosis and CPT treatment codes as well as traditional coding references.
Inputs information necessary for insurance claims and ensures claim information is complete and accurate. Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper CMS-1500 form.
Submits claims to all forms of insurance and follows up with insurance carriers on unpaid or rejected claims within required timeframes.
Leads the revenue cycle management process, including, but not limited to, insurance verification, claims submission, claims management, and reporting.
Researches and resolves client billing problems or issues.
Documents payment records and issues as they occur.
Answers patient questions on patient responsible portions, copays, deductibles, write-offs, etc. Resolves patient complaints or explains why certain services are not covered.
Processes and follows up on payer denials, consulting with the patient and/or his or her family as needed.
Posts payments within required timeframes and updates the ledger in the electronic health record.
Follows up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
Prepares appeal letters to insurance carrier when not in agreement with a claim denial. Collects necessary information to accompany the appeal.
Prepares patient statements for charges not covered by insurance. Ensures statements are mailed on a regular basis as determined by the programs. Follows up on unpaid statements at regular intervals.
Works with patients and the Financial Services Department to coordinate payments that patients file directly with their insurance company.
May work with patients to establish payment plans for past-due accounts in accordance with provider policies. May perform “soft collections” for patient past due accounts.
Submits delinquent or past due accounts to a collections agency and provides necessary information to collection agencies for delinquent or past due accounts.
For patients with coverage by more than one insurer, prepares and submits secondary claims after processing by primary insurer.
Follows HIPAA guidelines in handling patient information.
Creates insurance or patient aging reports using medical practice billing software to identify unpaid insurance claims or patient accounts.
Tracks managed care authorizations and limits to coverage, when applicable.
Ensures all insurance and client payments are deposited into appropriate program accounts on a daily basis.
Participates in departmental emergency planning and response activities.
Promotes public health within the community.
Takes personal responsibility to provide exceptional customer service in order to promote and maintain a positive Public Health image, constructive working environment, and foster pride and professionalism in the workplace and community.
Performs other duties as required.

Supervision Exercised: This classification does not have supervisory authority and requires no supervision or direction of others.

Supervision Received: Receives intermittent supervision. This classification normally performs the job by following established standard operating procedures and/or policies. Regular direction, guidance, and coaching from supervisor is expected. There is a choice of the appropriate procedure or policy to apply to duties. Performance reviewed periodically.

Qualifications
Knowledge, Skills & Abilities

Strong knowledge of medical ICD-10 codes and CPT medical billing codes.
Strong knowledge of insurance claims processing and claims resolution. Knowledgeable on insurance and reimbursement process.
Familiarity with electronic health record systems or the ability to learn electronic health system modules necessary for billing and payment management.
Familiarity with HIPAA privacy requirements for patient information. Ability to maintain the security of sensitive and confidential information.
Excellent verbal and written communication skills; excellent telephone and patient relation customer service skills.
Ability to read and understand explanation of benefits (EOB) statements.
Ability to conduct thorough Accounts Receivable follow-up.
Ability to work independently and in a team environment.
Ability to assess situations and make prudent and appropriate decisions; ability to apply conflict resolution and problem-solving skills.
Ability to perform under pressure and when confronted with persons acting under stress.
Ability to work in a fast-paced environment, manage multiple tasks, reprioritize as work situations change, and meet all required deadlines.
Ability to work with a high level of detail. Skilled in writing and maintaining accurate records and reports to meet management objectives.
Ability to use standard office equipment, including telephone, computer, Microsoft office applications, fax machine, and copier.
Maintain regular and punctual attendance.

Required Education & Experience

High school diploma or equivalent education.
Three years of medical billing experience.

Associate’s degree in a related field may substitute for one year of the required experience.
Bachelor’s degree in a related field may substitute for two years of the required experience.
Experience logging and applying payments.

Preferred Education & Experience

Two years of education in a Medical Billing certificate program.

Pre-Employment RequirementsMust pass conditional post offer background investigation and drug screen.
Work Conditions
Duties are primarily performed in an office environment. Public Health employees are responsible for providing proof of vaccinations and/or tuberculosis testing as applicable to the specific position and must provide proof of completion of required vaccinations/testing or proof of initiation within sixty days of hire date. This is a part-time position regularly working up to 25 hours per week.

The classification specification above is intended to represent only the key areas of responsibilities and minimum qualifications; specific job assignments, duties, education, experience, licenses/certifications, and environmental conditions will vary depending on the needs of the department/office and the particular assignment. Changes to this document may only be made by a member of the Human Resources Department.