Job description
Medical Billing Specialist –
Southwoods Executive Centre
Our mission is simple: provide services unparalleled in quality and efficiency while cultivating an environment that emphasizes the individual needs of each of our patients. We understand patients have a choice when it comes to their healthcare. So we combined the most advanced technology, with comprehensive, quality care and the finest patient experience this area has to offer to make that choice easier.
Job Summary:
This position is responsible for submitting claims and statements to third-party payers and guarantors. Resolve edits daily within the EMR or clearinghouse. Maintain correspondence regarding billing questions.
Insurance billing duties
Our mission is simple: provide services unparalleled in quality and efficiency while cultivating an environment that emphasizes the individual needs of each of our patients. We understand patients have a choice when it comes to their healthcare. So we combined the most advanced technology, with comprehensive, quality care and the finest patient experience this area has to offer to make that choice easier.
Job Summary:
This position is responsible for submitting claims and statements to third-party payers and guarantors. Resolve edits daily within the EMR or clearinghouse. Maintain correspondence regarding billing questions.
Insurance billing duties
- Verify accuracy of patient’s insurance company name/address
- Determine need for any supporting documentation required by the insurance company/case and copy documents for inclusion with claim form
- Understand and abide by billing compliance regulations
- Determine patient’s insurance type and whether to bill using HCFA1500 form or UB92; verify answer with insurance contract
- Send original claims along with any supporting documentation to insurance companies
- Submit claim to patient’s secondary insurance (including primary carrier’s EOB) after receiving correct payment from primary carrier
- Process account checks daily in Meditech.
- Perform month end manual process to submit claims.
Patient billing duties
- Verify accuracy of insurance payments received/posted
- Verify accuracy of adjustments
- Understand and abide by billing compliance regulations
- Submit patient statement files to vendor daily.
Billing calls/correspondence
- Assist customer service representatives with questions, whether from patients or insurance companies
- Answer billing questions in a clear and polite manner; pull business charts/computer files as necessary to answer questions
- Forward all questions regarding refunds to applicable supervisor
- Forward all complex/problem questions to applicable supervisor
- Answer all letters from insurance companies regarding questions or requests for information
- Understand patient confidentiality laws and what signatures are required to release information
- Direct any insurance company’s request for reduction of payment to applicable supervisor
- Follow up with collections representative or business office manager on any problem claims regarding coding/supply charges
Qualifications:
Required
- Training/courses in business office activities
- Third-party-payer billing experience
Preferred
- Two or more years’ billing experience Medical front office experience 1-2 years
- Proficient in medical terminology, MA or completion of other healthcare program.
Work Site Highlights:
Founded in 1996, Southwoods Health has grown from a physician owned Ambulatory Surgery Center with four operating rooms to a multi-service, physician owned health system. The Surgical Hospital at Southwoods is an acute care hospital renowned for providing a superior patient experience and consistently ranking at the top of national patient satisfaction and quality of care surveys. The hospital continues to expand its scope of services, which includes inpatient, outpatient and robotic-assisted surgery, as well as endoscopy services. Southwoods offers a provider network comprised of hundreds of physicians and advanced practice providers, as well as an expanding array of ancillary health services at locations across Mahoning, Trumbull and Columbiana Counties – all of which are certified to meet Southwoods’ high operational standards. Southwoods Health is an Equal Opportunity Employer.
Full-time. Monday – Friday dayshift.
www.southwoodshealth.com
#SWH2022
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