|Job Title||Billing Specialist|
|Location||Sonoma County, CA|
|Department||Billing / Collections|
The Billing Specialist will spend much of the workday verifying patient insurance information and billing Kaiser ambulance transport claims, as well as sending and receiving faxes and placing outgoing phone calls to other health care providers to obtain documentation required for billing.
- The Billing Specialist may be assigned one or more duties. These duties may include, but are not limited to, the following:
- Review patient care reports (PCR) for complete and correct documentation following the documented procedure
- ICD-10 coding and charge entry on medical claims
- Adhere to specific Medicaid and Medicare invoicing requirements.
- Collaborate effectively with the team to ensure prompt resolution to billing discrepancies involving paperwork issues
- Demonstrate a high degree of familiarity with paperwork standards and required level of documentation
- Communicating with Patients and Patients Representatives to obtain insurance information while offering excellent customer service
- Processing all correspondence with adherence to the Health Insurance Portability and Accountability Act (HIPAA) guidelines where applicable. Maintaining knowledge of functional area and company policies and procedures
- Heavy data entry and computer work
The Billing Specialist may be assigned one or more additional duties. These duties may include, but are not limited to, the following:
- Providing feedback to management concerning possible problems or areas of improvement.
- Making recommendations to implement improved processes.
- Performing other duties as assigned by management.
- Attend all mandatory meetings and trainings.
- Responding to verbal and/or written inquiries in a timely manner.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The individual in this position must possess the following qualifications:
- Experience with billing medical professional claims
- Knowledge of medical terminology
- Knowledge, understanding, and compliance with company policies and procedures.
- Ability to maintain the highest level of confidentiality.
- Proficient personal computer skills.
- Excellent interpersonal, written, and oral communication skills.
- Ability to work in a team fostered environment.
- Ability to multitask and work in a fast-paced environment.
- Ability to prioritize and organize work.
- Ability to adapt to a flexible schedule.
The individual in this position must possess the following education requirements:
- High school diploma or GED. College degree preferred.
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
While performing the duties of this job, the employee is regularly required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb or balance; stoop, kneel, crouch, or crawl; and talk or hear. The employee must regularly lift and/ or move up to 15 pounds. Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus.
Occasionally: Must have the ability to lift, carry and balance up to 15 pounds.
Frequently: Good manual dexterity, typing 40 wpm, with the ability to perform all tasks related to the position of Billing Specialist.
Constantly: Ability to sit and stand for extended periods of time, to speak and enunciate clearly and at an audible level. Ability to hear and understand information provided verbally in person or via telephone and have correctable vision in order to read medical documentation and other documents in electronic and hard copy format.
The mental demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.
Occasionally: Memorization, critical judgment, problem solving.
Frequently: Simple and complex mathematic skills, reasoning, ability to read, interpret and correspond in various written communication formats.
Constantly: Logic, ethical judgment and reasoning, active listening skills, decision making, ability to communicate effectively in written and verbal formats.
The individual in this position must be familiar with using the following equipment to perform the essential functions of this job.
Occasionally: Fax machine, copy machine, hole-punch, calculator, and laminator.
Frequently: Printer, clock.
Constantly: Telephone, computer.
The working environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Travel; approximately 0-10% of time.
While performing the duties of this job, the employee occasionally works near moving mechanical parts and is occasionally exposed to risk of electrical shock.
The noise level in the work environment is low to moderate.
The statements in this document are intended to describe the general nature and level of work performed by individuals assigned to the classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. This document in no way constitutes a contract of employment. Falck Northern California reserves the right to modify job descriptions, policies or any other procedural documents at any time, for any reason without prior notice.