Professional Billing Specialist - Revenue Cycle_Prof Billing Kahi Mohala (Full-Time, 40, Day)

I. JOB SUMMARY/RESPONSIBILITIES:

• Performs accurate and timely billing of patient accounts in accordance with policies and procedures of The Queen’s Health Systems (QHS) and in compliance with federal, state, insurance carriers, health plans and other third party payor requirements, as assigned.
• Ensures accurate claims submission to optimize revenue for the Medical Center, as assigned.
• Responds to patient and insurance inquiries promptly and courteously.
• Follows-up on payment with insurance payers and patients on outstanding accounts.
• Expedites larger dollar accounts to ensure prompt payment. Monitors to ensure all insurance balances are paid in a timely manner.

II. TYPICAL PHYSICAL DEMANDS:

• Operates various office equipment such as computer, copier, facsimile, telephone, typewriter, etc.
• Essential: standing, sitting, walking, seeing, hearing, speaking, finger dexterity, repetitive arm/hand motions and gripping of an object.

III. TYPICAL WORKING CONDITIONS:

• Some exposure to communicable diseases and other conditions common to a hospital and office environment.
• Not substantially subjected to adverse environmental conditions.

IV. MINIMUM QUALIFICATIONS:
A. EDUCATION/CERTIFICATION AND LICENSURE:

• Associate’s or Bachelor’s degree in business administration, finance, accounting or healthcare related field preferred.
• High school diploma or equivalent education.

B. EXPERIENCE:

• Experience with Windows applications, such as Word, Excel, etc., demonstrated proficiency in using mouse and keyboard.
• Experience with computer based applications, preferably in SMS and/or EPIC systems.
• Knowledge of Medicaid, Medicare, Third Party payer requirements, SNF/ICF, ICD-10 and DRG’s.
• One (1) year professional billing experience, preferably in a comparable organization. An Associate’s or Bachelor’s degree in business administration, finance, accounting or healthcare related field may be substituted for one (1) year experience in professional billing.
• Knowledge of medical terminology.
• Experience and/or background to demonstrate effective written and verbal communication skills in English.