Department :

Administration Job Status :

Full Time FLSA Status :

Non-Exempt Reports To :

Director of Revenue Cycle Grade/Level :

Amount of Travel Required :

>15%

Work Schedule :

Positions Supervised :

None 8 a.m. to 5:30 pm Monday

Thursday.

8 a.m. to 12:00 pm on Friday. However, adjustments in schedule or additional hours may be required to complete duties.

POSITION DESCRIPTION

The Billing Specialist is responsible for all medical and/or dental billing and accounts receivable actions of the organization. The Billing Specialist will conduct accurate and timely billing activities and reporting daily. He/she will perform all duties in a manner that maximizes collections and minimizes denials. The Billing Specialist should be absolutely honest and follow all insurance, state, and federal rules and laws. The Billing Specialist is involved in continuous Quality Improvement practices and measures as set by Mainline Health Systems, Inc. and in which the practice focus is based on a Patient Centered Medical Home model of care. These practices and measures are given to the Billing Specialist by the Chief Quality Officer.

SPECIFIC DUTIES AND RESPONSIBILITIES

Responsible for the timely and accurate submission of all claims assigned. Responsible for collection of all payments in a timely manner. Responsible for all patient billing and maintaining acceptable collection ratios. Responsible for the proper coding of all claims processed as needed. Responsible for applying for all Medicaid, Medicare, and Commercial Insurance numbers as needed. Responsible for all patient payment plans. Business-related travel as required. Participates in quality improvement practices. Act as additional administrative support to the care team; supporting the implementation of workflows that sustain MHSI Patient Centered Medical Home model of care. Willingness to attend and/or complete continuing education related to this position and/or any other topics as deemed necessary to MHSI. Completion of continual job training processes set forth by Mainline Health Systems, Inc. Performs other duties as directed by the Director of Revenue Cycle.

REPORTING RELATIONSHIPS

The Billing Specialist reports to the Director of Revenue Cycle.

EVALUATION

The evaluation of work performance will be ongoing and will be completed by the Director of Revenue Cycle. It will include the specific duties and responsibilities of this position description plus employee ability to interact constructively with clinical and administrative staff and general working behavior. Formal evaluation will be conducted annually but may be initiated at other times by the Director of Revenue Cycle.

PHYSICAL DEMANDS

Physical Demands Lift/Carry Stand O (Occasionally) Walk O (Occasionally) Sit F (Frequently) Handling / Fingering F (Frequently) Reach Outward O (Occasionally) Reach Above Shoulder O (Occasionally) Climb N (Not Applicable) Crawl N (Not Applicable) Squat or Kneel O (Occasionally) Bend O (Occasionally) 10 lbs or less F (Frequently) 11-20 lbs O (Occasionally) 21-50 lbs O (Occasionally) 51-100 lbs N (Not Applicable) Over 100 lbs N (Not Applicable) Push/Pull 12 lbs or less O (Occasionally) 13-25 lbs O (Occasionally) 26-40 lbs O (Occasionally) 41-100 lbs N (Not Applicable) N (Not Applicable) Activity is not applicable to this occupation. O (Occasionally) Occupation requires this activity up to 33% of the time (0

2.5+ hrs/day) F (Frequently) Occupation requires this activity from 33%
66% of the time (2.5
5.

5+ hrs/day) C (Constantly) Occupation requires this activity more than 66% of the time (5.5+ hrs/day) Other Physical Requirements Vision (Near, Color) Sense of Sound (telephone and verbal conversations) Sense of Touch

QUALIFICATIONS

A Bachelor s degree preferred and High School Diploma required. Certification in Medical Coding preferred. Certification in Dental Coding preferred. Two years of experience in medical billing and/or health care setting preferred. Working knowledge of total quality management concepts, statistical tools, and continuous quality improvement techniques. Experience with the reporting and operating requirements of primary care programs funded by HRSA. Any equivalent combination or experience and education

STATUS:

This is a FLSA Non-Exempt position. This is an OSHA low risk position. This is an ADA negotiable position.

DISCLAIMER

The duties and responsibilities, qualifications, physical conditions and other statements contained herein represent the current general nature of the job described, and are subject to change at any time, with or without notice. 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