Billing Specialist

General Description

Under the general supervision of the Fiscal Support Officer, responsible for generating and submitting healthcare claims to insurance companies to ensure healthcare providers are reimbursed for their services.

Minimum Qualifications ( Education and Experience)

High School graduate (or GED) with at least one (1) year of related experience;

Or

Successful completion of one academic year of study above the high-school level in a resident business or secretarial school, junior college or university.

Minimum Qualifications (Necessary Knowledge, Skills and Abilities)

Must:

• Have considerable knowledge of office methods and techniques


• Be skilled in the use of computer programs including word processing, spreadsheets, internet, and email


• Have excellent interpersonal and communication skills with the ability to communicate effectively, both orally and in writing


• Be able to establish and maintain effective working relationships with coworkers


• Be able to maintain a cooperative working relationship with coworkers and those contacted during the workday


• Maintain confidentiality of all records and information


• Operate standard office equipment


• Understand and follow Bear River Health Department policies and procedures.

Special Qualifications

Must:

• Be able to pass a full background check and drug screening


• Possess or be able to obtain a valid Utah Driver License at the time of employment


• Be able to provide your own transportation


• Be able to lift 50 pounds and be able to perform strenuous activities requiring flexibility and stamina, and overall general good health


• Have a flexible schedule and be available for scheduled work in the evenings and/or weekends and holidays as the job requires.

Summary of Duties 

• Monitor daily charges and payments


• Reconcile Medicaid and collection accounts including verifying eligibility and resolving Medicaid issues


• Reconcile statements


• Account adjustments – itemize accounts, drop encounters, review claims, post accounts, correct billing errors


• Call insurance companies and clearinghouse for benefit eligibility, pre-authorization, check claim status, correct rejections and resubmit


• Send accounts to collections


• Post and balance EFT deposits


• Prepare daily reports


• Process refunds


• Use ICD-10 and CPT codes for claims


• Update provider licensing, certifications and credentialing


• Obtain contracts and negotiate with insurance companies


• Act as a liaison between providers and health plans


• Respond to public health emergencies as required.