Billing Specialist 1 - PB | 1.0 FT

Phelps Health is a 2000-employee-strong hospital and healthcare system serving the heart of small-town Missouri.

No matter where you start with us, we’re committed to taking our team to the top. If you’re ready for the challenge of providing life-saving care or supporting those who do, read on to find your fit in the Phelps Health family.

General Summary

The Billing Specialist I is responsible for collecting and entering claims, post insurance, submit claims, and answer patient inquiries on accounts. Reports to the Billing Supervisor.

Essential Duties and Responsibilities

• •Enters information necessary for insurance claims such as patient, insurance, and insurance ID. Insures claim information in complete and accurate.
• •Submits insurance claims to clearinghouse or individual insurance companies electronically or via paper UB04 and/or CMS-1500 form.
• •Answers patient questions on patient responsible portions, copays, deductibles, write-off's, etc. resolves patient's complaints or explains why certain services are not covered.
• •Follow up with insurance company on unpaid or rejected claims. Resolves issues and re-submits claims.
• •Prepares appeal letters to insurance carrier when not in agreement with claim denial. Collect necessary information to accompany letter.
• •Follows HIPAA guidelines in handling patient information.
• •May perform "soft" collections for patient past due accounts. This may include contacting and notifying patients via phone or mail.
• •Understand managed care authorizations and limits to coverage such as number of visits.
• •Verify patient benefits eligibility and coverage as needed.
• •Prepares and submits secondary claims upon processing by primary insurer.
• •Standards of Behavior
• •Integrity: I believe in being personally accountable for doing what is always right.
• •Compassion: I believe in acting on the empathy felt toward the needs of patients and families.
• •Innovation: I believe in being inspired to provide care in new and creative ways.
• •Philanthropy: I believe in being a good steward of the gift of time, deeds and resources for our patients and community.
• •Job Qualifications

Education

High School Diploma or GED required.

Work Experience

Medical billing experience highly preferred. Experience in billing software and electronic data submission preferred.

Certification/License

Mental/Physical Requirements

Ability to receive and express detailed information through oral communications, visual acuity, and the ability to read and understand written directions. Normal mental concentration with repetitive operations for a long period of time. Ability to stand, walk, sit, and reach. Occasionally lifts and transports items weighing up to ten (10) pounds. .

Working Conditions

Standard office conditions with more than average noise. Periodic contact with conditions such as fumes, noise, chemicals, hazards, and/or diseases.

At Phelps Health, we think we have a better team, benefits, and opportunities for growth than anyone else around, and we invite you to see for yourself! Apply now to join us on our mission in health care.