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REVENUE (BILLING) SPECIALIST
Job Code:2022-FB-003
Location:CLINIC
Preferred Experience:Some Experience Required
Minimum Experience:Entry Level
Job Category:Regular Full Time
  

Come work for Marimn Health - voted one of the Best Places to Work in the Inland Northwest in 2018, 2019, 2020 and 2021 and Modern Healthcare's Family Friendliest Employer in 2020! Fantastic benefits, flexible schedules, paid holidays and ability to choose vacation times!

Please note that this position is in Plummer, ID. Carpool opportunities are available.

QUALIFICATIONS: A high school diploma or GED is required. Two years’ experience in a medical billing office required. This position requires a thorough understanding of medical billing, transaction processing, electronic claims transmission, charge and payment posting, claims denial resolution, governmental and private payer claims submission requirements, patient eligibility inquiry and financial reporting. Advanced courses in accounting and finance are desired. A minimum of one year prior experience working with a clinical electronic practice management and electronic health record system is required. Candidates must possess an understanding of all phases of the process of producing, transmitting and recording the financial portion for all clinical charges, payments and adjustments including Medical, Dental, and Behavioral Health.  An understanding of grant reporting requirements desired. An understanding of FQHC/Tribal billing requirements desired.

ADA ESSENTIAL FUNCTIONS:

  • Hearing: within normal limits with or without use of corrective hearing devices.
  • Vision: adequate to read 12-point type with or without use of corrective lenses.
  • Must be able to verbally interact with staff, clients and public.
  • Manual dexterity of hands/fingers for writing and data entry.
  • Able to lift up to 25 lbs.
  • Standing 25-75% of the day.
  • Walking 25% of the day.
  • Pushing up to 25 lbs.
  • Pulling up to 25 lbs.

ESSENTIAL RESPONSIBILITIES:

  • Works with other members of the Revenue department to insure that all claims, payments and adjustments are processed in a timely manner.
  • Confirms patient insurance eligibility.
  • Processes charges from the EHR into the EPM and prepares encounters for billing.
  • Creates electronic claims as required and prepares non electronic claims for mailing.
  • Works the A/R as directed to insure the timely collection of billed encounters.
  • Follows up on unpaid or contested claims with the expectation of resolving issues to facilitate payment.
  • As required, posts payments and adjustments to individual encounters.
  • As required, understands and is able to prepare the clinic day sheet for deposit and transaction posting.
  • Processes credit balances and refunds as directed by department policy.
  • Works with the Purchased and Referred Care department to maintain the correct IHS eligibility in the EPM.
  • Understands diagnosis and charge coding sufficiently to recognize errors or inconsistencies when processing charges.
  • Works as required with software and clearinghouse vendors to insure transmission of claims.
  • Maintains a positive relationship with co-workers and clients.
  • Works with staff and clients to resolve issues regarding insurance, billing and payments.
  • Maintains reports as required to assist with departmental of clinic needs.
  • Understands HIPAA regulations and all federal, state, and local governmental requirements regarding billing and complies with the contractual requirements of third party payers.
  • Understands and is in compliance regarding the requirements of all grants and funding sources used by the clinic for clinical services.
  • Participates in meetings, training and committees as required.
  • Seeks training opportunities and maintains any certificates required to perform job duties.
  • Keeps abreast of changes affecting the processes required to successfully manage the clinic A/R.
  • Other duties as assigned.
  •  Understands the rules regarding confidentiality and follows those rules.
  • Understands and follows clinic policies in all areas.