Billing Specialist

St. Louis, MO

We are South City Hospital. Our primary function is to offer continuous nursing, medical, and other health and social services on a 24-hour basis, under physician directed care and RN supervision.

We service a multitude of patients and their families across our vast network, while remaining committed to the professional development of our staff, the functional improvement of our patients, and the cultivation of strong partnerships within our communities. 

WHAT WE OFFER 

  • Essential/stable and growing company with many opportunities for training and advancement within the medical field that all employees and team members (including Full-Time and Part-Time) can benefit from. 
  • Hourly pay is negotiable based on experience. We offer competitive market pay and opportunities for bonus depending on great work performance (bonuses only apply for Full Time). 
  • Comprehensive Employee Benefits: Full-Time employees are eligible for various plans for medical, dental, and vision insurance. 

The Billing Specialist is responsible for the daily electronic billing of claims that are uploaded into billing system and in compliance with current billing rules and regulations. Upholds the standards established by the Patient Account Manager and/or Director.

PRIMARY RESPONSIBILITIES

  • By 2pm daily, submits claims electronically  and/or hard copy  to appropriate 3rd party vendor from data provided by the medical coders.
  • Verifies patients insurance coverage if claim edits out on billing system for name and ID number do not match.
  • Stays abreast of current billing rules and regulations ensuring we are following per current rules and regulations.
  • Works collaboratively with hospital departments for problem resolution.
  • Daily recognition of the Billing system edits and resolution of issues to ensure accurate billing.
  • Responsible for ensuring completion of assigned reports from EMR.
  • Ensures issues are identified and corrected in a timely manner for Medicare claims.
  • Submits appeals to payors when appropriate, for hospital and patients.
  • Review, analyze, and identify any Medicare overpayments and responsible for sending out the quarterly credit balance report to CMS.
  • Attendance at patient account department meetings presenting issues for revenue cycle improvement.
  • Follows department policy and procedures to ensure the maintenance if adequate documentation to meet audit requirements. Provides timely reports as required within job duties. Ensures accuracy of work at all times.
  • Works in a collaborative, constructive, cooperative team member within the business office. Assists other office personnel in the performance of their job duties as assigned.
  • Performs other duties as assigned.

EDUCATION/EXPERIENCE 

  • High school graduate or equivalent; additional college training preferred
  • Minimum 3 years Patient Accounting experience, with emphasis on Managed Care and Government billing regulations.
  • Medical terminology required.
  • Knowledge of contract terminology as it relates to healthcare
  • Ability to communicate effectively, both verbally and in writing, with customers     
  • Ability to resolve problems with minimal assistance.
  • Proficient in computer skills necessary to perform job duties.
  • Strong interpersonal skills and organizational skills