Phelps Health

Regional health system employing clinical staff

Billing Specialist 1

Accounts Payable/ReceivableConfirmed live in the last 24 hours

Full-timeMissouri, USANo salary listedIn-person

About the Job

Requirements

A high school diploma or GED is required.
The ability to receive and express detailed information through oral communications, visual acuity, and the ability to read and understand written directions is required.
The role requires normal mental concentration for repetitive operations over a long period.
The role requires the ability to stand, walk, sit, and reach, and occasionally lift and transport items weighing up to ten pounds.

Responsibilities

Enter patient, insurance, and insurance identification information needed for insurance claims, ensuring the information is complete and accurate.
Submit insurance claims electronically to a clearinghouse or individual insurance companies, or on paper using UB-04 and/or CMS-1500 forms.
Answer patient questions about patient-responsible portions, copayments, deductibles, and write-offs; resolve complaints or explain why services are not covered.
Follow up with insurance companies on unpaid or rejected claims, resolve issues, and resubmit claims.
Prepare appeal letters to insurance carriers when contesting claim denials and collect information to accompany the letters.
Follow HIPAA guidelines when handling patient information.
Perform soft collections for past-due patient accounts, including contacting and notifying patients by phone or mail, as needed.
Understand managed-care authorizations and coverage limits, such as visit limits.
Verify patient benefits eligibility and coverage as needed.
Prepare and submit secondary claims after the primary insurer processes the claim.

Desired Qualifications

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

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.

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

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.

About the Company

Phelps Health

Regional health system employing clinical staff

Phelps Health operates a regional health system that delivers clinical care and related services through a broad team of clinicians and support staff. Its product is the patient care experience and health services provided across hospitals and clinics, including nurses, care providers, and non-clinical roles that together shape treatment, recovery and patient support. The company differentiates itself by being one of the region’s largest employers and by a clear emphasis on integrity, compassion, innovation and philanthropy, offering a wide range of career opportunities that impact the patient experience. Its goal is to improve community health by delivering high-quality care, supporting its staff, and contributing to philanthropic efforts that benefit patients and the broader region.

Company size: 201-500
Company stage: Not listed
Total funding: Not listed
Headquarters: Rolla, MO
Founded: Not listed

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