Billing Specialist (Bryan Physician Network)

GENERAL SUMMARY:

The BPN Billing Specialist is responsible for the accurate submission of all claims to third-party payers according to policy and billing regulations and the collection of accounts from third party payers and patients. Ensures that compliance standards are supported and works closely with patients, families, attorneys, outside agencies, third-party payers and internal Bryan Health personnel to secure resolution of accounts while maintaining superior customer service. Responsible for clerical duties as assigned.

PRINCIPLE JOB FUNCTIONS:

1. *Commits to the mission, vision and beliefs of Bryan Health and consistently demonstrates our core values.

2. *Performs necessary clerical duties to complete billing tasks and document appropriate communication; files work documents and reference materials as needed.

3. *Responsible for following up and processing returned claims, reports, requests for information and resubmissions.

4. *Monitors all outstanding unbilled claims and reports any concerns to manager

5. Provides support to Central Business Office (CBO) personnel as requested.

6. Receives incoming mail and distributes to appropriate staff.

7. Answers patient billing calls.

8. Posts incoming checks and processes remittance advice from payers accurately.

9. Works denials on the Explanation of Benefits (EOB) to completion.

10. *Maintains current billing guidelines and third party payer regulations.

11. *Reviews all claims for correct and complete patient and insurance information.

12. Performs other related projects and duties as assigned.

(Essential Job functions are marked with an asterisk "*").

REQUIRED KNOWLEDGE, SKILLS AND ABILITIES:

1. Knowledge of credit and collection practices

2. Knowledge of third party regulations.

3. Knowledge of general medical billing, coding practices and regulations.

4. Knowledge of federal regulations including COBRA, HIPAA, Medicare and Medicaid.

5. Knowledge of computer hardware equipment and software applications relevant to work functions.

6. Skill in inter-personal communications and problem resolution.

7. Ability to establish and maintain effective working relationships with all levels of personnel and medical staff.

8. Ability to organize and maintain filing systems.

9. Ability to prioritize work demands and work with minimal supervision.

10. Ability to communicate effectively, professionally and respectfully verbally and in writing.

11. Ability to maintain confidentiality relevant to sensitive information.

12. Ability to exercise courtesy and professionalism in receiving office callers and visitors.

13. Ability to maintain regular and punctual attendance.

EDUCATION AND EXPERIENCE:

High school diploma or equivalent required. Minimum of two (2) years insurance billing experience in a clinic or hospital setting required. Prior patient accounting experience desired.