Greater Baltimore Medical Center (GBMC)
Billing Specialist I
Greater Baltimore Medical Center (GBMC), Cockeysville, Maryland, United States, 21030
Under direct supervision, performs all billing and collection functions on account balances within assigned financial classes. Ensures timely submission of all claims and timely follow up. Posts payments in EPIC. Perform eligibility, verification and authorization requests, as needed.
Education High School diploma or equivalent required. Associate's degree preferred.
Experience Two years of medical billing experience and one year experience with electronic billing. Epic experience desired.
Knowledge, Skills and Abilities
Thorough knowledge and understanding of medical billing, insurance and private pay.
Knowledge of all medical billing requirements for Medicare, Blue Cross, Medical Assistance, Commercial insurance, and HMO carriers
Strong collection skills, including claims follow-up, revenue cycle practices
Strong computer skills, including EMR knowledge and Microsoft Office. Excel preferred.
Strong interpersonal skills
Excellent verbal and written communication skills for interacting with patients, families, insurance companies and healthcare providers.
Strong ability to investigate issues, find solutions, and work under pressure to resolve billing issues.
Efficient in managing multiple tasks, prioritizing, and ensuring deadlines are met.
Ability to handle multiple claims and billing tasks simultaneously while maintaining quality and accuracy
Licensures, Certifications N/A
Principal Duties and Responsibilities
Manages assigned Epic work queues daily to ensure accurate billing and expedient claims follow-up.
Claims Billing Processes: Ensures timely submission of all claims within assigned financial classes. Ensures timely follow up of all claims within assigned financial classes.
Claim Resolution Processes: Investigates claim denials or rejections; completes functions in order to resolve claims.
Uses all available tools such as Online access, calling the insurance companies; working with provider representatives.
Identifies appeals; identifies secondary billing for accounts with secondary liability; follows-up on any unpaid balances. Brings these claims to resolution.
Identifies patient self-pay balances and bills timely to patient/family. Follow-ups as necessary including calling for follow up.
Process any late charge claims, claims resubmission and/or claims corrections to payors.
Enters and posts payment to patient accounts based on remittance advice review.
Reconcile accounts and ensure any underpayments or overpayments are corrected
Responds to patient and third-party payor inquiries regarding patient accounts via e-mail, telephone, mail, and in person.
Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission.
Maintain detailed and accurate billing records for auditing purposes and compliance with industry regulations
Maintain thorough records of all communication with insurance providers and patients regarding claims.
Participate in meetings with Provider Reps to resolve denial discrepancies
Prepare and submit appeals for denied claims. Understanding of additional documentation necessary to submit an appeal
Obtain an in-depth understanding of hospice billing regulations. Ensure compliance with federal, state and local billing laws, including HIPAA regulations.
Prepare reports to managers recommending accounts for bad debt adjustments. Maintaining lost revenue at a level of less than 1% of net healthcare revenue
Recommends accounts for transfer to bad debt.
Physical Requirements
Ability to sit, concentrate and pay close attention to detail
Working Conditions
Normal office environment with little exposure to excessive noise, dust, temperatures and the like
Conditions of Employment N/A
All roles must demonstrate GBMC Values GBMC Values
Respect
What follows describes GBMC values without formatting; text retained from the original content.
Treats others with fairness, kindness, and respect for personal dignity and privacy
Listens and responds appropriately to others' needs, feelings, and capabilities
Excellence
Pays attention to detail; follows through
Meets and/or exceeds customer expectations
Actively pursues learning and self-development
Pays attention to detail; follows through
Accountability
Sets a positive, professional example for others; takes ownership of problems and does what is needed to solve them.
Sets a positive, professional example for others
Takes ownership of problems and does what is needed to solve them
Appropriately plans and utilizes required resources for various job duties
Reports to work regularly and on time
Teamwork
Engaged and collaborative; keeps people informed.
Works cooperatively and collaboratively with others for the success of the team
Addresses and resolves conflict in a positive way
Seeks out the ideas of others to reach the best solutions
Acknowledges and celebrates the contribution of others
Ethical Behavior
Acts with honesty and integrity; protects the patient.
Demonstrates honesty, integrity and good judgment
Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
Results
Sets goals and measures outcomes that support organizational goals. Seeks and accepts help to achieve goals.
Embraces change and improvement in the work environment
Continuously seeks to improve the quality of products/services
Displays flexibility in dealing with new situations or obstacles
Achieves results on time by focusing on priorities and manages time efficiently
Pay Range
$19.34 - $29.00
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.
Equal Employment Opportunity
GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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Education High School diploma or equivalent required. Associate's degree preferred.
Experience Two years of medical billing experience and one year experience with electronic billing. Epic experience desired.
Knowledge, Skills and Abilities
Thorough knowledge and understanding of medical billing, insurance and private pay.
Knowledge of all medical billing requirements for Medicare, Blue Cross, Medical Assistance, Commercial insurance, and HMO carriers
Strong collection skills, including claims follow-up, revenue cycle practices
Strong computer skills, including EMR knowledge and Microsoft Office. Excel preferred.
Strong interpersonal skills
Excellent verbal and written communication skills for interacting with patients, families, insurance companies and healthcare providers.
Strong ability to investigate issues, find solutions, and work under pressure to resolve billing issues.
Efficient in managing multiple tasks, prioritizing, and ensuring deadlines are met.
Ability to handle multiple claims and billing tasks simultaneously while maintaining quality and accuracy
Licensures, Certifications N/A
Principal Duties and Responsibilities
Manages assigned Epic work queues daily to ensure accurate billing and expedient claims follow-up.
Claims Billing Processes: Ensures timely submission of all claims within assigned financial classes. Ensures timely follow up of all claims within assigned financial classes.
Claim Resolution Processes: Investigates claim denials or rejections; completes functions in order to resolve claims.
Uses all available tools such as Online access, calling the insurance companies; working with provider representatives.
Identifies appeals; identifies secondary billing for accounts with secondary liability; follows-up on any unpaid balances. Brings these claims to resolution.
Identifies patient self-pay balances and bills timely to patient/family. Follow-ups as necessary including calling for follow up.
Process any late charge claims, claims resubmission and/or claims corrections to payors.
Enters and posts payment to patient accounts based on remittance advice review.
Reconcile accounts and ensure any underpayments or overpayments are corrected
Responds to patient and third-party payor inquiries regarding patient accounts via e-mail, telephone, mail, and in person.
Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission.
Maintain detailed and accurate billing records for auditing purposes and compliance with industry regulations
Maintain thorough records of all communication with insurance providers and patients regarding claims.
Participate in meetings with Provider Reps to resolve denial discrepancies
Prepare and submit appeals for denied claims. Understanding of additional documentation necessary to submit an appeal
Obtain an in-depth understanding of hospice billing regulations. Ensure compliance with federal, state and local billing laws, including HIPAA regulations.
Prepare reports to managers recommending accounts for bad debt adjustments. Maintaining lost revenue at a level of less than 1% of net healthcare revenue
Recommends accounts for transfer to bad debt.
Physical Requirements
Ability to sit, concentrate and pay close attention to detail
Working Conditions
Normal office environment with little exposure to excessive noise, dust, temperatures and the like
Conditions of Employment N/A
All roles must demonstrate GBMC Values GBMC Values
Respect
What follows describes GBMC values without formatting; text retained from the original content.
Treats others with fairness, kindness, and respect for personal dignity and privacy
Listens and responds appropriately to others' needs, feelings, and capabilities
Excellence
Pays attention to detail; follows through
Meets and/or exceeds customer expectations
Actively pursues learning and self-development
Pays attention to detail; follows through
Accountability
Sets a positive, professional example for others; takes ownership of problems and does what is needed to solve them.
Sets a positive, professional example for others
Takes ownership of problems and does what is needed to solve them
Appropriately plans and utilizes required resources for various job duties
Reports to work regularly and on time
Teamwork
Engaged and collaborative; keeps people informed.
Works cooperatively and collaboratively with others for the success of the team
Addresses and resolves conflict in a positive way
Seeks out the ideas of others to reach the best solutions
Acknowledges and celebrates the contribution of others
Ethical Behavior
Acts with honesty and integrity; protects the patient.
Demonstrates honesty, integrity and good judgment
Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
Results
Sets goals and measures outcomes that support organizational goals. Seeks and accepts help to achieve goals.
Embraces change and improvement in the work environment
Continuously seeks to improve the quality of products/services
Displays flexibility in dealing with new situations or obstacles
Achieves results on time by focusing on priorities and manages time efficiently
Pay Range
$19.34 - $29.00
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs.
Equal Employment Opportunity
GBMC HealthCare and its affiliates are Equal Opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.
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