Patient Accounts - Commercial Billing Specialist - FT - WHMG Job Listing at Wilson Health in Sidney, OH (Job ID 8a7885a89881bbba0198c89a503f702f)

Description

Wilson Health is looking for a direct hire COMMERCIAL Billing Specialist for our Patient Accounting Department located in Sidney, Ohio (North Dayton, Ohio) area.

Key Perks and Benefits:

• Sick Leave (Full Time & Part Time Sick Leave Program)
• Insurance (Medical, Dental, Vision, Long Term Disability, Life, and Others)
• Managed Time Off (Full Time & Part Time Managed Time Off)
• Retirement (Defined Contribution, Employer Contribution, Employer Match, and Various Investment Options)
• Education Reimbursement (Tuition &  Book Fee Reimbursement)
• Access to Employer Direct Care Clinic - Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
• Generous paid time off program beginning day one.
• Medical Insurance: Your Choice of Two High Deductible Health Plan Options or a PPO, Dental and Vision Insurance. Coverage is effective the first of the month after date of hire.
• H S A with employer contribution for eligible health plans, FSA for medical and dependent care expenses
• Company Paid Life Insurance, Short- and Long-Term Disability Insurance
• Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance.
• Industry leading retirement plan - employer contributions begin day one, no waiting period for participation.
• Tuition Assistance Program.
• On site employee fitness center

Employment Status: Full Time (FT=36+ hours)
Working Hours: 40 hours a week (80 hours per pay period)
Schedule: Monday - Friday (No Weekends or Holidays)
Shift: 1st shift - Hours are Flexible - 6:30am - 5pm, option to work remote 3 days a week, after being on-site for 6 months 
and able to perform all required duties.
Option to work 4 - 9 hour days and 4 hours on Fridays - schedule is flexible.
Position Reports to: Manager of Patient Accounts   
                       
Department Description: Wilson Health's Patients' Account Department is responsible for handling the hospital billing and collection aspects of the patient's care during the service date (The date/date(s) when care was provided to the patient from the hospital or provider).

Job Summary: 
Under the direction of the Manager of Patient Accounts the Commercial Billing Specialist releases Commercial claims electronically and mails hard copy 1500 claims as required.
The Commercial Billing Specialist will follow up on unpaid claims and rebill or Appeal claims as indicated.
Commercial Billing Specialist works the On-Line system for rejections and pended claims.

RESPONSIBILITIES OF MEDICARE BILLING SPECIALIST: 

Essential Duties & Responsibilities: include the following.  Other duties may be assigned. 

• Effectively present information and respond to questions from groups of managers, staff members, patients, patient families, outside agencies and the general public. 
• Billing of Commercial Payer claims through Epic, which requires keeping up to date with Payer requirements and/or edits. 
• This would include the pediatric client, the adolescent client, the young-middle aged adult client and the geriatric client. 
• Ability to read and comprehend simple instructions, short correspondence and memos. 
• Ability to write simple correspondence
• Ability to effectively present information in one-on-one and small group situations to customers, clients and other employees of the origination.
• Submits claim electronically or hard copy for MSP claims with appropriate information from the primary payer. 
• Bills secondary, tertiary, etc. claims electronically or mails the 1500 with EOB as required by Payer. 
• Monitors claims using the payer websites 
• Works closely with all departments throughout the hospital regarding charges and/or late charges. 
• Responsible for follow-up of Commercial Payers. 
• Works the 30 day and out worklist in Meditech/Epic and contacts Payers via phone or Payer web site regarding no pays. 
• Makes contact with the patient when necessary to secure payment 
• Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons.   Biller also follows up on the Appeal. 
• Works mail as it applies to the Commercial Biller to secure payment 
• Works closely with physician offices, physician coders, and registration regarding denials for no Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal. 
• Works Cash Report daily to ensure proper payment from Payers and makes appropriate adjustments as required. 
• Submits documentation to Manager of Patient Accounts for refunds 
• Receives phone calls from patients regarding account balances, itemized bill or Explanation of Benefits.

 

• Other Skills and Abilities: 
• Accurate typing skills, computer keyboard skills and data entry.  
• Knowledge of medical terminology, CPT and HCPCS codes. 
• Calculator skills. 
• Ability to work in a highly stressful environment. 
• Ability to adapt to change.  
• Knowledge of Excel.  
• Organization and prioritizing skills.  
• Ability to communicate with co-workers.

Qualifications:

• 1+ Year Previous hospital billing experience. Medical terminology and understanding of CPT and ICD 10 codes.
• High school diploma or general education degree (GED)
• To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. 
• The requirements listed above are representative of the knowledge, skill and/or ability required.  
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. 
• The ability to communicate with a professional friendly personality to the customer is essential.  
• Internet skills and the ability to navigate through different systems. 

Mission & Vision & Values:
Improve the health and wellness of the community by delivering compassionate, quality care.
Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence
 

 Apply on company website