Patient Financial Services - Billing Specialist - FT

Gibson-Area-Hospital-; Gibson City (IL); On-site; USD 42,000 - 52,000; Full time

Job summary

Gibson Area Hospital & Health Services in Gibson City, IL is seeking a CBO Representative to handle accurate and timely billing and follow-up for all claims to ensure prompt payment from payers.

This full-time role (8:00–4:30, M-F) involves running daily billing reports, communicating with patients and insurers about status and billing questions, and ensuring timely follow-up in accordance with established policies.

Qualifications

• General knowledge of mathematics and accounting principles.
• Previous experience with billing forms for different insurance plans.
• Knowledge of Medical Terminology.
• Familiar with legal and ethical compliance in charging and billing.
• Previous experience in the policy and procedures of billing.
• Analytical skills to evaluate claims for errors in billing and payment from payers.
• Knowledge of patient rights.
• Good communication skills to assist patients with billing questions and concerns.
• AAHAM CRCS certification preferred.

Responsibilities

• Run required daily reports for preparation of billing follow-up of patient accounts with all Medicare, Medicaid, Blue Cross, Commercial and all third parties.
• Make outgoing and receive incoming calls and answer inquiries from patients, insurance companies and all other parties regarding the status and billing questions concerning claims.
• Ensure appropriate, accurate/timely follow-up to all insurance companies based on established policies and procedures.
• Review patient account information received from admissions and out patient registration. Identify any missing information and determine what avenue to take to ensure timely follow-up.
• Adequately respond to billing questions and provide clarification to customers.
• Develops and maintains appropriate communication with insurance payers, outside agencies and internal departments.
• Refer all non-routine issues to management for clarification.
• Update and prepare correspondence to customers and insurance payers as necessary.
• Communicate customer needs with the appropriate level of urgency.
• Process and scan all EOBs/Correspondence received within 2 business days.
• Re-bill and reprocess all Denials and Rejections ensuring all avenues are explored to resolve issues with Insurance Payers.
• Take incoming calls from patients regarding their insurance and billing.
• Process all walk-ins
• Resolution of Credit Balance reports Monthly.
• Work with fellow staff in a professional, courteous and respectful manner at all times.
• All other duties assigned by Director of PFS or Executive Director of Revenue Cycle.
• Work the denial program daily.

Skills

Billing knowledge

Customer communication

Analytical skills

Education

Medical Terminology knowledge

AAHAM CRCS certification preferred

Job description

Job Details

Job Location: Gibson City, IL 60936

Position Type: Full Time

Salary Range: $20.00 - $25.00 Hourly

HOURS & SHIFT REQUIREMENTS: Full time, 8:00 – 4:30 M-F

GENERAL SUMMARY

The CBO Representative is responsible for accurate and timely billing and follow-up of all claims to ensure prompt payment from all payers. This would include all communication and research regarding patient accounts with all departments involved.

GIBSON AREA HOSPITAL & HEALTH SERVICES MISSION STATEMENT

To provide personalized, professional healthcare services to the residents of the Communities we serve.

PRINCIPLE DUTIES AND RESPONSIBILITIES

• 1. Run required daily reports for preparation of billing follow-up of patient accounts with all Medicare, Medicaid, Blue Cross, Commercial and all third parties.
• 2. Make Outgoing & Receive incoming calls and answer inquiries from patients, insurance companies and all other parties regarding the status and billing questions concerning claims.
• 3. Ensures appropriate, accurate/timely follow-up to all insurance companies based on established policies and procedures.
• 4. Review patient account information received from admissions and out patient registration. Identify any missing information and determine what avenue to take to insure timely follow-up.
• 5. Adequately responds to billing questions and provide clarification to customers.
• 6. Develops and maintains appropriate communication with insurance payers, outside agencies and internal departments.
• 7. Appropriately refers all non-routine issues to management for clarification.
• 8. Accountable for updating and preparing correspondence to customers and insurance payers as necessary.
• 9. Effectively communicate to customers needs with the appropriate level of urgency.
• 10. Process and scan all EOB’s/Correspondence received within 2 business days.
• 11. Re-bill and reprocess all Denials and Rejections ensuring all avenues are explored to resolve and issues with Insurance Payers.
• 12. Take incoming calls from patients regarding their insurance and billing.
• 13. Process all walk-ins
• 14. Resolution of Credit Balance reports Monthly.
• 15. Ability to work with fellow staff in a professional, courteous and respectful manner at all times.
• 16. All other duties assigned by Director of PFS or Executive Director of Revenue Cycle.
• 17. Work the denial program daily.

QualificationsPHYSICAL REQUIREMENTS

• 1. Work requires knowledge of PC’s keyboard, calculations, copy machine, printers and other office equipment.
• 2. Light level of physical effort required for a variety of physical activities to include lifting, standing and sitting at a workstation for up to four hours at a time. Physical strength to perform the following lifting tasks:
  • Floor to waist - 10 pounds
  • Waist to shoulder - 10 pounds
  • Shoulder to overhead - 10 pounds
  • Carry 10 pounds for 15 feet
• 3. Work requires visual acuity necessary to observe and obtain information and use documentation.
• 4. Auditory acuity to hear others for purposed of fluent communication.

REPORTING RELATIONSHIP

Reports to the Director of Patient Financial Services.

EDUCATION, KNOWLEDGE AND ABILITIES REQUIRED:

• 1. General knowledge of mathematics and accounting principles.
• 2. Previous experience with billing forms required for different insurance plans.
• 3. Knowledge of Medical Terminology.
• 4. Familiar with the Legal and Ethical Compliance in charging and billing.
• 5. Previous experience in the policy and procedures of billing.
• 6. Requires analytical skills to evaluate claims for errors in billing and payment from payers.
• 7. Knowledge of patient’s rights.
• 8. Good communication skills to assist patients with billing questions and concerns.
• 9. AAHAM CRCS certification preferred.

INFECTION EXPOSURE RISK LEVEL

Category 3 - No Risk - Your job does not involve exposure to blood, body fluids or tissue. You do not perform or help in emergency medical care or first aid as part of your job.

WORKING CONDITIONS

• 1. Works in an office where there are relatively few discomforts due to dust or dirt. There is some exposure to print noises.
• 2. Will work in an office with co-workers where traffic may be constant, subjecting your work to interruptions, which can produce stress and fatigue.