Job Details

Business Office Specialist

Our hospitals provide high-quality care that transforms the lives of those living with disabling injuries and illnesses.

Interested in this role You can find all the relevant information in the description below.

We distinguish ourselves through our commitment to excellence, to our patients, to our employees, and to the communities we serve.

The business office specialist position is responsible for the daily activities of the central business office accounts receivable, which include the preparation, submission and collection of insurance claims, Medicare/Medicaid billing, third party payer billing, and payment posting.

Must have hospital billing, collections, Medicare and commercial health care insurance experience.

Prepares, processes, and files accurate and timely insurance claims for all payer types in accordance with department policy and payer requirements.

Analyzes, interprets, and resolves all billing edits to ensure claims are filed accurately within the payer's regulations and filing limits.

Adheres to compliance and regulatory rules as mandated by CMS, state and federal regulations, payer contracts, and established department policies and procedures.

Processes and monitors all refunds, adjustments, corrections, etc.

Monitors compliance of proper billing practices in accordance with federal, state, local standards, guidelines, and regulations.

Prepares end of day, month and year to comply with financial policy and procedures.

Handles correspondence related to the billing of a claim for all lines of business, answers questions and updates accounts as necessary.

Assists in cost containment development of the department within budgeted parameters; reviews bad debt activity.

Accurately posts payments to patient accounts.

Oversees monthly cash reconciliations and reporting.

Updates and reviews all accounts to keep records up to date, follow up with payer on unpaid claims.

Resolves denials, appeals, and other payer issues, works with hospital personnel when required. xywuqvp