Here at Savista, we enable our clients to navigate the biggest challenges in healthcare: quality clinical care with positive patient experiences and optimal financial results. We partner with healthcare organizations to problem solve and deliver revenue cycle improvement services that enable their success, support their patients, and nurture their communities, all while living our values of Commitment, Authenticity, Respect and Excellence (CARE).
The Billing Specialist II is responsible for the timely submission of technical or professional medical claims to insurance companies.
Duties & Responsibilities
- Utilize various hospital/physician systems to verify patient, billing and claim information for accuracy
- Perform compliant primary/secondary, tertiary and rebill billing functions which can include electronic, paper and portal submission to payers
- Edit claims to meet and satisfy billing compliance guidelines for electronic and hardcopy submission
- Respond timely to emails and telephone messages as appropriate
- Communicate issues to management, including payer, system, or escalated account issues
- Participate and attend meetings as requested, training seminars and in-services to develop job knowledge
- Serves and protects the hospital community by adhering to professional standards, hospital policies and procedures, federal, state, and local requirements, and JCAHO standards
- Enhances billing department and hospital reputation by accepting ownership for accomplishing new and different requests; exploring opportunities to add value to job accomplishments
- Update patient demographics/insurance information in appropriate systems
- Monitor claims for missing information, authorization, and control numbers (ICN//DCN)
- Follows guidelines for prioritization, timely filing deadlines, and notation protocols within appropriate systems
- Secure needed medical documentation required or requested by third party insurance carriers
- Maintain and respect the confidentiality of patient information in accordance with insurance collection guidelines and corporate policy and procedure
- Utilize provider billing manuals to obtain billing guidelines and requirements
- Import verification and escalation of import/export files
- Special Handling billing included not limited to interim bills, overlap review, redistribution of money for correct claim creation
- Resolve and research billing Rejections
Qualifications & Competencies
- 2+ years of medical collections/billing experience
- Intermediate knowledge of ICD-10, CPT, HCPCS and NCCI
- Intermediate knowledge of third-party billing guidelines
- Intermediate knowledge of billing claim forms (UB04/1500)
- Intermediate knowledge of payor contracts
- Working Knowledge of Microsoft Word and Excel
- Intermediate working knowledge of health information systems (i.e., EMR, Claim Scrubbers, Patient Accounting Systems, etc.)
Preferred Qualifications
- Working knowledge of one or more of the following Patient accounting systems - EPIC, Cerner, STAR, Meditech, CPSI, Invision, PBAR, All Scripts, or Paragon
- Working knowledge of DDE Medicare claim system
- Knowledge of government rules and regulations
Note: Savista is required by state-specific laws to include the salary range for this role when hiring a resident in applicable locations. The salary range for this role is from $16.00 to $22.63. However, specific compensation for the role will vary within the above range based on many factors including but not limited to geographic location, candidate experience, applicable certifications, and skills.
SAVISTA is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race, color, age, veteran status, disability, national origin, sex, sexual orientation, religion, gender identity or any other federal, state or local protected class.
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