DETAILS

SUMMARY: All Billing Representatives are responsible for accurate and timely processing Billing/Collection/Payment/Claims/Accounts Receivable duties assigned to each person’s role.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following; other duties may be assigned:

Standard Competencies

  • Displays courtesy and sensitivity while managing difficult and emotional customer situations. Solicits feedback to improve service and responds promptly to customer’s needs.
  • Schedules time off in advance to ensure proper coverage for department.  Also begins working on time and works independently throughout the day until it is time to end shift.
  • Accepts responsibility for own actions and is able to meet commitments.  Asks for help from immediate supervisor when necessary.
  • Able to follow policies and procedures while supporting the goals and values of the organization.  Also promotes a positive work environment for staff of all departments offering support while working cooperatively with all co-workers.
  • Expresses ideas and thoughts effectively.  Displays confident communication skills and exhibits good listening.  Keeps other adequately informed while selecting appropriate forms of communication.
  • Shows a strong initiative and willingness to learn, continually strives to increase personal productivity.  Always treats others with respect and consideration as committing to do the best job possible.

Billing & Collection – 30%

  • Responsible for following policies and procedures as documented in the Billing & Collection Policies.
  • Complies with all organizational policies and procedures in regard to HIPAA and Release of Information
  • Utilizes the Electronic Health Record (EHR) and the Practice Management system appropriately to perform established work plan duties.

Data Reporting and Posting – 50%

  • Responsible for timely and accurate posting of insurance payments.
  • Accurately processes electronic payments through practice management system.
  • Applies sliding-fee scale discounts, third-party disallowances, and other gross revenue adjustments and ensure they are recorded in an accurate and timely manner.
  • Responsible for monitoring overpaid/refund status for accounts.
  • Maintains, organizes and evaluates billing records for accuracy and completeness.
  • Responsible for ensuring encounters, procedures, and other revenue-producing services are recorded accurately in accordance with applicable regulatory guidelines and TBCHS’s established criteria.
  • Verifies and updates patient demographic and insurance information to produce clean claims for the revenue cycle.
  • Ensures sliding-fee scale discounts are applied accurately to full charges when deemed appropriate and that public insurance funds are utilized when appropriate.

Communication – 20%

  • Responds to patient and staff billing questions effectively and appropriately.
  • Works with supervisor to troubleshoot billing-related issues within directed time frames.
  • Processes patient complaints per established policies.

SUPERVISORY RESPONSIBILITIES: This job has no supervisory responsibilities.

EDUCATION and/or EXPERIENCE: High school diploma or general education degree (GED); and two years related experience and/or training.

CERTIFICATES, LICENSES, REGISTRATIONS: This job has no certification, license, or registration requirements.

PHYSICAL DEMANDS: Light

TRAVEL: Travel between sites may be required.

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