Billing Specialist

ESSENTIAL DUTIES AND FUNCTIONS

* Responsible for all patient phone calls and in-person/clinic interactions related to billing.

* Conduct research, resolve and communicate patient billing discrepancies and adjustments.
* Work with Member Services to communicate updated insurance demographics and sliding fee documentation and as well as assist front desk staff to help ensure patient demographic, insurance, sliding fee and proof of income (POI) is accurately entered/updated in the system.
* Enter Medical Record charges in patient accounts.
* Work closely with providers and other clinical staff to ensure accuracy of billing.
* Maintain smooth patient flow.
* Communicate as needed with insurance plans on billing issues.
* Communicate information regarding patient billing activities and issues to the Controller and Finance Team.
* Demonstrate ability to be viewed as a subject matter expert in their current role.
* Organize work/resources to accomplish objectives and meet deadlines.
* Demonstrate personal responsibility for job performance.
* Maintain relationships with health plans, healthcare providers, other professionals, coworkers and patients.
* Participate in quality improvement activities.
* Demonstrate a cooperative team approach in activities.

Other Duties
* Attends additional training sessions to improve deficiencies and enhance knowledge/skills.
* Performs other duties and functions, which facilitate interdisciplinary team process and are consistent with demonstrated competencies.
* Attends and participates in all-staff, departmental and targeted meetings consistently.

QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential job function assigned satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education
* High School diploma or GED. Business school or equivalent preferred.

Experience:
* Minimum one year of experience in a medical/hospital setting AND/OR Medical Office Assistant Certificate.
* Medical Terminology, preferably in a billing or revenue cycle department
* Strong knowledge of HIPAA rules & regulations

Skills/Competencies:
* Excellent written and verbal communication skills
* Self-learner
* Time management
* Ability to work independently with limited supervision
* Demonstrates positive attitude
* Works collaboratively with colleagues within and outside the department, including external vendors
* Demonstrates flexibility in accepting, changing, or completing duties & responsibilities
* Proficiency with Microsoft Word and Excel
* Proficiency with office machines, i.e. adding machine, FAX, copier, PC, etc.
* Excellent knowledge of Hawaii insurance, including QUEST and managed care plans

Certifications:
* TB clearance within previous 12 months.
* Fully vaccinated against COVID-19 or approved reasonable accommodation for medical or religious exemption.

Ethics and Law
* Demonstrates a strong commitment to adhering to professional ethics and compliance with the laws and regulations governing healthcare organizations.

Interpersonal Skills
* Demonstrates conflict resolution skills and knows when to ask.
* Understands and follows the organizational structure and reporting lines when addressing problems.
* Possesses mindfulness skills, strong self-awareness, and emotional management in a team environment.
* Establishes, maintains, and promotes strong and cooperative working relationships with all staff and ability to work with a diverse population.


Safety and Compliance
* Attends all required in-service and external training related to Safety and Compliance.
* Reads, watches safety & health videos, and adheres to all policies and procedures in Safety and Health Guidebook

DECISION MAKING
* Makes independent decisions on routine activities within scope and function of the position and refers non-routine decisions to manager or controller.