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Insurance Billing Specialist

Singing River Health System
Pascagoula

Job Description

The Insurance Billing Specialist submits hospital claims to multiple third party payers including, but not limited to: Managed Care plans; Medicare and Medicaid; hospice and other specialty claims. He/She coordinates accumulation and verification of all necessary documentation required for billing and resolves claim level edits and errors as appropriate for accurate, compliant billing. The Insurance
Billing Specialist performs follow up duties associated with re-billing, claim level denials, adjustments and collections of all overdue accounts in accordance with best business practices. He/She identifies problems and solutions or enhancements to resolve billing issues, including, billing frequency, required forms, and general billing requirements. The Insurance Billing Specialist communicates issues
and offers suggestions to service line departments and management to improve processes within the Revenue Cycle.

Education
High school graduate or equivalent required. Courses in business, accounting, or related fields preferred.

License
N/A

Certification
N/A

Experience
A minimum of two (2) years experience in patient accounting, insurance or a business office required. Experience with diagnosis codes, procedure and CPT codes, NCCI edits, modifiers, and standard payer reported code sets preferred.

Physical Demands
Work is moderately active: involves sitting with frequent requirements to move about the office, move about the facility, and to travel to another facility within the SRHS service area. Work involves exerting a negligible amount of force frequently to lift, carry, push, pull, or otherwise move objects, including the human body. Work involves using repetitive motions: substantial movements of the wrists, hands and/or fingers while operating standard office equipment such as computer keyboard copier and 10-key.

Work involves being able to perceive the nature of sound at normal speaking levels with or without correction; the ability to make fine discriminations in sound. Work requires close visual and acuity and the ability to adjust the eye to bring an object into sharp focus, i.e. shift gaze from viewing a computer monitor to forms/printed material that are closer to compare data at close vision.

Must be able to work for extended periods of time without experiencing undue fatigue. Must be able to work flexible hours.

Mental Demands
Must demonstrate keen mental faculties/assessment and decision making abilities. Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone. Must demonstrate strong written and verbal communication skills. Must possess emotional stability conducive to dealing with high stress levels. Must demonstrate ability to work under pressure and meet deadlines.

Attention to detail and the ability to multi-task in complex situations is required. Must have strong analytical and interpersonal skills.

Special Demands
Must possess superior customer service skills and professional etiquette. Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.). Must have working knowledge of MS Outlook, Word, Excel, and PowerPoint. Work requires the ability to function independently, adapt to workload demands, set priorities, and understand and set goals. Must understand the fundamentals of automated data processing, and be able to quickly gain a detailed understanding of complex computerized and non-computerized information.

Must possess knowledge of medical, coding, and billing terminology. Must have an understanding of Revenue Cycle functions in a hospital setting and thorough knowledge of state and federal laws, as they apply. Must be able to navigate within an Electronic Medical Record (EMR).

Must successfully pass Alphanumeric Data Entry Test with a score of 50% or better.

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