Billing Specialist (4347)

Waco Family Medicine; Bellmead (TX); On-site; USD 32,000 - 52,000; Full time

Job summary

Waco Family Medicine is seeking a Full Time Billing Clerk at the Bellmead Administration Office. You will manage patient accounts, verify coverage, and handle billing with insurance carriers and state programs.

Strong communication and computer skills are essential for daily interactions with patients and staff. The role requires knowledge of ICD-10-CM/CPT coding, billing practices, and financial assistance programs, with attention to accuracy and confidentiality in a fast-paced clinic

Qualifications

• High school diploma or equivalent required; college hours preferred.
• Knowledge of ICD-10 CM/CPT coding and medical billing practices.
• Experience with billing and collections and financial assistance programs.
• Strong interpersonal, oral and written communication skills.
• Proficient computer literacy and phone/customer service skills.

Responsibilities

• Maintain current knowledge of insurance carrier/state program claims filing policies; update as needed.
• Verify patient demographics and financial coverage; update as needed.
• Research and verify patient/insurance refunds/recoupments.
• Adjust accounts for changes in payment responsibility.
• Verify accuracy of paper claim forms and mail to carriers.
• Research charges not automatically assigned; correct and assign manually.
• Maintain patient accounts; apply discounts/adjustments as needed.
• Appeal service charges rejected by carriers and resubmit forms.
• Process claims/vouchers for plans and programs.
• Obtain pre-certifications, prior-authorizations, or referrals as needed.
• Verify motor vehicle/accident information with insurer.
• Maintain work queues with claim errors.
• Assist carriers/state programs to acquire patient info for processing.
• Assist patients in understanding fees and billing processes.
• Assist patients with payment arrangements and financial assistance.

Skills

Computer literacy

ICD-10 CM/CPT coding

Billing and collections

Interpersonal skills

Oral and written communication

Telephone etiquette

Customer service skills

Education

High School Diploma or Equivalent

College hours preferred

Job description

Job Details

Job Location: Bellmead Administration Office - Bellmead, TX 76705

Position Type: Full Time

Education Level: High School

Travel Percentage: None

Job Shift: Day

Job Category: Admin - Clerical

PRIMARY DUTIES

• Maintain a current knowledge of insurance carrier and/or state program claims filing policies and procedures
• Verify patient demographics and financial coverage; update as needed
• Research and verify patient and/or insurance company and/or state program refunds/recoupments
• Adjust patients accounts to reflect changes in payment responsibility
• Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and/or state programs
• Research patient charges not automatically assigned to selected insurance carriers and/or state programs, make corrections and assign manually
• Maintain patient accounts; give GHC program discounts and/or other adjustments as needed
• Appeal service charges rejected by selected insurance carriers and/or state programs and resubmit amended claim forms
• Process claims/vouchers as needed for insurance plans and/or state programs
• Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
• Verify motor vehicle or accident information with patient’s insurance carrier
• Maintain work ques with claim errors
• Assist insurance carriers and/or state programs to acquire supplemental patient information needed to process claims
• Assist patients to understand fees for services and billing processes
• Assist patients to make payment arrangements and find financial assistance
• Assist outside providers and vendors to obtain physician billing information
• Assist employees to understand policies and procedures related to billing matters
• Communicate and support training issues with billing staff
• Comply with all regulations related to confidentiality of patient information
• Maintain and/or create new payor and plans as needed
• Able to manage multiple priorities and manage stress appropriately
• Communicates appropriately and clearly with a pleasant and professional manner to all
• Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
• Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
• Maintain certifications and website passwords as applicable

OTHER DUTIES

• Assist in scheduling patient appointments
• Process billing statements and balance notification letters to patients
• Assist patients to make payments on owed balances
• Provide follow-up on patient’s payment arrangements
• Assist with daily mail duties
• Provide backup support for clerks and other billing staff as needed
• Other duties as assigned by supervisor

PHYSICAL AND MENTAL REQUIREMENTS:

• Visual and auditory accuracy
• Shift length – 8 hours
• Indoor setting
• Continuous use of computer, calculator
• Long periods of sitting and walking
• Frequent use of telephone
• Frequent use of stepladder
• Continuous repetitive grasping and manipulation of both hands
• Continuous conversational communication
• Occasional reaching, standing, squatting, bending, kneeling, twisting and climbing
• Occasional carrying, lifting, pushing and pulling of up to 10 Lbs
• Infrequent use of personal transportation
• Working in a frequently noise environment
• Continuously working in a tight area
• Understand/carry out simple/detailed, oral/written instructions
• Memorize and retain instructions
• Read and interpret detailed specifications

Qualifications

REPORTS TO: Director of Billing Services

EDUCATION: High School Diploma or Equivalent required, College Hours preferred

SKILLS: Computer literacy, knowledge of ICD-10 CM/CPT coding, medical office billing and collection practices, federal/state/local financial assistance programs, strong interpersonal, oral, and written communication skills, excellent telephone, and customer service skills.