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
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.