Job Description

The Billing and Collection Specialist is responsible for all aspects involved in bringing hospital and physician accounts to full payment and resolution. This role engages problem solving skills in order to ensure any roadblocks are resolved in the follow-up and billing process. The Billing and Collection Specialist is a focused individual who understands what is needed to collect outstanding balances and conclude accounts with a positive outcome. This position is based onsite with potential for hybrid work schedule.

JOB RESPONSIBILITIES

• The Billing and Collection Specialist is responsible for ensuring that cash goals are met on a monthly basis.
• Ensures that accounts are appropriately coded to system requirements for management of open accounts.
• Reports any unusual occurrences and difficult collection issues to PFS Supervisor and PFS Manager.
• Ensures all billing activity is posted to A/R system.
• Obtains medical records from HIM in a timely manner and ensures all that is needed for payment is attached at the time of billing.
• Monitors unbilled accounts and prepares status report weekly for PFS supervisor.
• Files corrected or late charge bills accurately and upon receipt of notification from data quality or PFS supervisor.
• Working with outpatient access and inpatient financial counselors, ensures all referrals and prior authorizations are completed and loaded in the system accurately prior to submission of bill.
• Obtains payer requested documents to ensure timely payment, i.e., med-pay letters, patient questionnaires, police reports, RA's/EOB's, medical records, etc.

REQUIRED MINIMUM EDUCATION

• High School Diploma. College preferred

REQUIRED MINIMUM CERTIFICATION

• CPAR (preferred)

REQUIRED LICENSURE

• N/A

REQUIRED MINIMUM EXPERIENCE

• Three (3) to five (5) years of experience with hospital and physician billing and collection processes.
• Inpatient, outpatient, and physician experience with billing and/or collections.

REQUIRED MINIMUM SKILLS

• Must have a working knowledge of PC spreadsheet and database software.
• Strong organizational skills required.
• Strong math aptitude required for analyzing payments and contractual agreements.
• Keyboard skills of 45 wpm.

PREFERRED QUALIFICATIONS

• N/A

PHYSICAL DEMANDS

• Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time.