Billing Specialist jobs in Utica, NY

Description

Job Summary:

Oneida Health is actively seeking a full-time Patient Account Representative - Billing Specialist to join our corporate offices. The incumbent will be responsible for the accurate and timely submission of healthcare services bills to governmental and third-party payers. The primary focus is to achieve a clean claim submission rate of 85% or greater, in alignment with established key performance indicators (KPIs). The role involves collaborating with the billing and claims management team, monitoring payer updates, and implementing corrective actions to enhance the overall efficiency of the billing process.

Key Responsibilities:

• Assist in the training and education of new staff hires under the supervision of the billing and claims management team.
• Monitor and share payer updates and bulletins with relevant stakeholders.
• Collaborate with the team to ensure an even distribution of workload.
• Review assigned claims daily for accuracy and perform necessary edit corrections.
• Submit claims and rebills to payers in manual and/or electronic formats for accurate and timely filing.
• Report recurring rejected claims to management for evaluation and take corrective actions.
• Analyze and report repetitive edit failures, proposing improvements to billing processes.
• Monitor bill holds and work lists, ensuring expeditious resolution and reporting of unresolved issues.
• Assist in resolving account balances promptly through appeals, correction of account information, and other necessary actions.
• Stay informed of changes in payer requirements and analyze and report repetitive denials.
• Achieve established productivity standards, providing cumulative reports as required by the supervisor.
• Document all actions taken on accounts in the system account notes.
• Maintain knowledge of applicable rules, regulations, and guidelines impacting patient account collections.
• Utilize payer websites effectively in the execution of daily tasks.
• Ensure compliance with patient confidentiality policies and regulations.
• Handle telephone information with courtesy, accuracy, and confidentiality.
• Communicate effectively with patients, staff, and supervisors, providing regular updates on ongoing projects.
• Follow the proper chain of command to resolve problems and concerns.
• Treat patients, families, and colleagues with respect, dignity, and confidentiality.
• Provide positive and productive support to the team, promoting teamwork and maintaining a professional demeanor.

Requirements:

If you are a skilled and experienced billing specialist seeking a challenging opportunity in a dynamic healthcare environment, we encourage you to apply. Join us in our commitment to delivering high-quality patient care and contributing to the success of our billing and claims management team.

Qualifications

Qualifications:

Education:

• • High School diploma; additional applicable education or certificates highly preferred.

Experience:

• • Five or more years of directly related experience in healthcare inpatient and outpatient billing.

Knowledge:

• • In-depth knowledge of healthcare medical terminology, billing, and coding.

Reimbursement Guidelines:

• • Intermediate knowledge of reimbursement guidelines for major third-party and governmental payers.

Skills:

• • Good communication, technical, and interpersonal skills.

Software:

• • Proficiency in PC, Microsoft Office Suite, internet use, and patient accounting systems.

HIPAA Compliance:

• • Understanding and compliance with HIPAA and Protected Health Information rules and regulations.

Soft Skills:

• Effective communication and interpersonal skills.
• Ability to work collaboratively in a team.
• Detail-oriented with strong organizational skills.
• Professionalism and respect for confidentiality.