Patient Accounts - Billing Specialist - Full Time

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)