Under direct supervision, coordinates and monitors all collections, cash posting, refunds, imaging, medical records functions and daily electronic billing operations for all hospital claims. Oversees work of Patient Account Specialist(s), Patient Accounts Assistant(s), Refunds Specialist and Optical Imaging Clerk(s). Those on the collections/self-pay team will also be required to serve as a representative of GBMC in court for collection of co-pays, deductibles or coinsurances.
Education: High School Diploma or GED Licensures/Certifications: Not Applicable Experience: Three years' experience to include two years of medical billing experience and one-year experience with electronic billing. Epic experience desired. Skills: * Thorough knowledge and understanding of medical billing, insurance and private pay. * Strong knowledge of all medical billing requirements for Medicare, Blue Cross, Medical Assistance, Commercial insurance, and HMO carriers * Strong collection skills, including claims follow-up and revenue cycle practices. * Knowledge of ICD-10 and CPT coding practices * Strong computer skills, including EMR knowledge and Microsoft Office. * Skill in data analysis and interpretation Strong interpersonal skills Principal Duties and Responsibilities: * Qualifies, processes and tracks monthly write-offs. * Audits primary patient bills for submission to third party payers via electronic billing or manual claim submission. * Follows up on patient and insurance balances via internet, telephone or other communication types. * Ensures secondary billing on accounts with secondary liability; follows-up on any unpaid balances. * Manages assigned Epic work queues daily to ensure accurate billing and expedient claims 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. * Responds to patient and third-party payor inquiries regarding patient accounts via e-mail, telephone, mail, and in person. * Recommends accounts for transfer to bad debt. All roles must demonstrate GBMC Values: Respect I will treat everyone with courtesy. I will foster a healing environment.
- Treats others with fairness, kindness, and respect for personal dignity and privacy
- Listens and responds appropriately to others' needs, feelings, and capabilities
Excellence I will strive for superior performance in every aspect of my work. I will recognize and celebrate the accomplishments of others.
- Meets and/or exceeds customer expectations
- Actively pursues learning and self-development
- Pays attention to detail; follows through
Accountability I will be professional in the way I act, look and speak. I will take ownership to solve problems.
- 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 I will be engaged and collaborative. I will keep 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 I will always act with honesty and integrity. I will protect the patient.
- Demonstrates honesty, integrity and good judgment
- Respects the cultural, psychosocial, and spiritual needs of patients/families/coworkers
Results I will set goals and measure outcomes that support organizational goals. I will give and accept 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 $18.86 - $28.30
Final salary offer will be based on the candidate's qualifications, education, experience and alignment with our organizational needs. COVID-19 Vaccination All applicants must be fully vaccinated against Covid-19 or obtain a GBMC approved medical or religious exemption prior to starting employment at GBMC Healthcare, to include Gilchrist and GBMC Health Partners. 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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