Patient Accounts - Billing Specialist - Full Time

Wilson Health
  • Sidney, Ohio
    30+ days ago

    Job Description

    Wilson Health is looking for a direct hire Billing Specialist for our Patient Accounting Department located in Sidney, Ohio (North Dayton, Ohio) area.
     
    Key Perks and Benefits:
    • Access to Employer Direct Care Clinic. Free medical care and pharmacy services for eligible employees and dependents covered by Wilson Health's medical insurance plan.
    • Generous paid time off (PTO) program beginning day one, designed to support work-life balance, rest, and time with family.
    • Medical Insurance: Choose from two High Deductible Health Plan (HDHP) options or a PPO plan, along with Dental and Vision coverage. Benefits begin on the first of the month following your hire date.
    • HSA with employer contribution for eligible health plans; FSA for medical and dependent care expenses.
    • Company-paid Life Insurance and Long-Term Disability Insurance
    • Voluntary Accident, Critical Illness, and employee and dependent Life and AD&D Insurance Industry-leading retirement plan – employer contributions begin day one with no waiting period for participation.
    • Tuition Assistance Program
    • Free access to an on-site gym, available 24/7, making it easy to prioritize your health and wellness before or after your shift.
    • Employees receive a 10% discount on food and beverages at the Wilson Cafeteria, Coffee Bar and Micro Mart
    Employment Status: Full Time (FT=36+ hours)
    Working Hours: 40 hours a week (80 hours per pay period) - ONSITE for 6 months, Hybrid remote option available.
    Schedule: Monday - Friday (No Weekend or Holidays)
    Shift: 1st shift  - FLEXIBLE hours between 6:30am - 5:30pm
    Position Reports to: Director of Revenue Integrity
                           
    Department Description: Wilson Health's Patients' Account Department is responsible for handling the hospital billing and collection aspects of the patient’s care during the service date (The date/date(s) when care was provided to the patient from the hospital or provider).
     
    Job Summary: The Billing Specialist is responsible for releasing insurance claims electronically and mails hard copy UB/1500 claims as required.
     The Billing Specialist will also follow up on unpaid claims and rebill or appeal claims as indicated.
     
    Essential Duties & Responsibilities:
    • Billing of claims through EPIC and Electronic Vendor (Quadax) which requires keeping up to date with Payer requirements and/or edits.
    • Prior experience with Medicare facility billing experience required
    • Submits claim electronically or hard copy for MSP claims with appropriate information from the primary payer.
    • Bills secondary, tertiary, etc. claims electronically or mails the UB/1500 with EOB as required by Payer.
    • Monitors claims using the Medicare  and or Quadax online system
    • Works closely with all departments throughout the hospital regarding charges and/or late charges.
    • Responsible for the follow up of submitted claims to primary, secondary, and tertiary payers
    • Works the 30 day and out worklist in EMR and contacts Payers via phone or Payer website regarding no pays.
    • Appeals claims on behalf of the patient to secure payment or if a claim has been denied for inappropriate reasons.  Biller or Collector will follow up on the Appeal.
    • Works with Case Management and Medical Records regarding RAC audits, other audits, and inpatient denials.
    • Works mail as it applies to the Biller or Collector to secure payment.
    • Works closely with Central Scheduling/Registration, Case Management and Medical Records regarding Denials for No Authorizations and/or Medical Necessity to secure appropriate documentation and/or diagnosis to submit a corrected claim or appeal
    Other Skills and Abilities: 
    • Accurate typing skills, computer keyboard skills and data entry.  
    • Knowledge of medical terminology,
    • CPT and HCPCS codes. 
    • Calculator skills. 
    • Ability to work in a highly stressful environment. 
    • Ability to adapt to change.  
    • Knowledge of Excel.  
    • Organization and prioritizing skills.  
    • Ability to communicate with co-workers.
    Qualifications:
    • 1+ Year Previous hospital billing experience. Medical terminology and understanding of CPT and ICD 10 codes.
    • EHR - Electronic Health Records (EPIC) required
    • High school diploma or general education degree (GED)
    Mission & Vision & Values:
    • Improve the health and wellness of the community by delivering compassionate, quality care.
    • Be a trusted, nationally-recognized leader of innovative, collaborative, community health.
    • A.S.P.I.R.E - Always serve with professionalism, integrity, respect, and excellence.
    EOE (Equal Opportunity Employer)

    Numbers & Facts

    LocationSidney, Ohio
    Websitehttps://www.wilsonhealth.org/

    Skills

    • Accidental Death and Dismemberment (AD&D)unmatched
    • Billingunmatched
    • Cafeteriaunmatched
    • Case Managementunmatched
    • Communication Skillsunmatched
    • Community Healthunmatched
    • Credit and Collectionsunmatched
    • Current Procedural Terminology (CPT)unmatched
    • Disability Insuranceunmatched
    • Documentationunmatched
    • Electronic Medical Recordsunmatched
    • Epic Systemsunmatched
    • Establish Prioritiesunmatched
    • Flexible Spending Accountsunmatched
    • Food and Beverage Industryunmatched
    • Health Insuranceunmatched
    • Health Planunmatched
    • Healthcare Common Procedure Coding System (HCPCS)unmatched
    • High Availabilityunmatched
    • Hospitalunmatched
    • ICD-10unmatched
    • Insuranceunmatched
    • Insurance Claimsunmatched
    • Life Insuranceunmatched
    • Medical Billingunmatched
    • Medical Record Systemunmatched
    • Medical Recordsunmatched
    • Medical Terminologyunmatched
    • Medicareunmatched
    • Microsoft Excelunmatched
    • Organizational Skillsunmatched
    • Patient Careunmatched
    • Patient Care Authorizationsunmatched
    • Patient Care Denialsunmatched
    • Pharmacyunmatched
    • Preferred Provider Organization (PPO)unmatched
    • Team Playerunmatched

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