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Specialist-Billing Senior - HS Central Business Office Corporate

Job ID: 21894
Job Category: Billing Claims and Revenue
Job Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Facility: BMHS - Regional Business Office Jackson
Location: Jackson, MS

Summary

Responsible for the daily completion of both claims edit, denial, and no response billing functions for timely follow up. Handles internal and external questions to completion. Understands both paper and electronic claims as well as client invoice billing. Performs other duties as assigned.

Responsibilities

Communicates in detail with the clinical and billing staff along with payers and clients regarding various insurance and payment related issues Bills and submits claims for all insurance companies according to payer specific guidelines and established procedures and workflow. Be knowledgeable of payer updates as it relates to bundling and unbundling charges, medical necessity and general coding specifications. Reviews and processes adjustments as needed for accounts to avoid claim release if not needed but also recognizes and resolves credit balances as needed. Resolves all front end claim edits and clearinghouse returns so that clailm can be resubmitted in a timely matter to payers/insurance carriers. Corrects all of the primary/secondary rejected claims, the resubmission of rejected claims in along with resolution of all delinquent insurance claim on patient accounts, per guidelines, in order to secure payment. Completes all assigned goals.

Requirements, Preferences and Experience

Experience

Minimum:

clerical skills with a working knowledge of accounting and insurance coverages and three (3) years, experience in a physicians or hospital setting. Good customer service skills are a requirement. Special Skills

Preferred:

Knowledge of ICD-9, ICD-10, CPT and HCPCS codes and certification and/or degree in Healthcare Administration Business, Finance or related fields preferred.

Minimum: Ability to type and key accurately, problem solving, written an d oral communication skills, financial counseling skills - knowledge of insurance billing (both hospital and professional settings) and collections - knowledge of insurance guidelines as it relates to CMS guidelines, TennCare and/or Medicaid based by state specified requirements. Ability to recognize and communicate to clinical staff or designee when insurance companies require additional review because of NCCI, CCI , LMRP, Mutually Exclusive and Medical Necessity edits. Effective Verbal, written and customer service skills as it relates to patients and insurance companies. Able to create communications to patients and insurance companies as needed to resolve issues to complete billing/claim processes.

Training

Preferred: Prefer knowledge of insurance billing and collections and insurance guidelines.

Minimum: PC skills and keyboarding

About Baptist Memorial Health Care

At Baptist, we owe our success to our colleagues, who have both technical expertise and a compassionate attitude. Every day they carry out Christ's three-fold ministry-healing, preaching and teaching. And, we reward their efforts with compensation and benefits packages that are highly competitive in the Mid-South health care community. For two consecutive years, Baptist has won a Best in Benefits award for offering the best benefit plans compared with their peer groups. Winners are chosen based on plan designs, premiums and the results of a Benefits Benchmarking Survey.

At Baptist, We Offer:
  • Competitive salaries
  • Paid vacation/time off
  • Continuing education opportunities
  • Generous retirement plan
  • Health insurance, including dental and vision
  • Sick leave
  • Service awards
  • Free parking
  • Short-term disability
  • Life insurance
  • Health care and dependent care spending accounts
  • Education assistance/continuing education
  • Employee referral program

Job Summary:
Position: 14583 - Specialist-Billing Senior
Facility: BMHS - Regional Business Office Jackson
Department: HS Central Business Office Corporate
Category: Billing Claims and Revenue
Type: Non Clinical
Work Type: Full Time
Work Schedule: Days
Location: US:MS:Jackson
Located in the Jackson, MS metro area
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