Job Description

Job Description

Job Description

JOB TITLE: Billing Associate

Fair Labor Standards Act (FLSA) Status: Non-exempt
Reports to: Revenue Cycle Coordinator

JOB SUMMARY: The Billing Associate is responsible for working closely with other members of the revenue cycle team in order to facilitate timely and accurate billing of claims for all of Spectra Health's clinical operations. They will work closely with other members of the billing department, and the patient access team to facilitate timely and accurate billing practices. This position reports directly to the Revenue Cycle Coordinator.

• ORGANIZATIONAL PHILOSOPHY:
  Privacy & confidentiality: Maintain strict adherence to privacy and confidentiality protocols, ensuring the protection of both patient and employee information in accordance with Spectra Health's policies.
• Champion organizational values: Promote and embody Spectra Health's core values of Compassion, Trust, Respect, Equity, and Inclusivity in all interactions and decision-making processes.
• Culture of safety: Foster a culture of safety; proactively addressing hazards, incidents, and security concerns while contributing to a positive and safe work environment for employees and patients.
• Teamwork & collaboration: Approach teamwork with a positive and collaborative mindset, building strong relationships across departments and sharing knowledge and experiences to enhance overall organizational effectiveness.
• Be part of the solution: Actively support organizational change, offering solutions, participating in leadership initiatives, and championing efforts that align with Spectra Health's evolving mission and
  goals.
• Patient-centered decision making: Prioritize the best interests of Spectra Health's patients, ensuring quality care and positive outcomes.
• Training & meetings: Complete mandatory training requirements and attend at least 80% of departmental meetings to stay informed and aligned with organizational goals and policies.
• Policy adherence & compliance champion: Strictly adhere to all Spectra Health policies and procedures, and act as a departmental advocate for Spectra Health's Compliance Program activities

ESSENTIAL JOB FUNCTIONS:

• Claims Management, including appeals, for outstanding and denied claims.
• Provides timely and professional customer service: verify discrepancies, and resolve patient billing

issues, answer questions from patients, staff, and third-party vendors.

• Facilitation of insurance and patient payments.
• Review and request refunds as necessary for patient and insurance overpayments
• Remains sensitive, yet assertive when assisting patients.
• Communicates billing updates/changes to appropriate staff.
• Identifies areas for improvement/efficiency and reports these to supervisor, as appropriate.
• Works closely with patient access staff to ensure accurate patient registration.
• Works closely and in conjunction with other health center staff.
• Follows HIPAA guidelines when accessing and sharing patient information.
• Maintains patient and business confidentiality.
• Supports additional coding, billing, and health center projects as needed.
• Perform other duties as assigned.

JOB QUALIFICATIONS:
Required:

• A high school diploma.
• Experience in healthcare billing.
• Excellent oral and written communication skills.
• Knowledge of CPT and ICD diagnostic codes.
• Working knowledge of Federal billing regulations and other insurers requirements.
• Technically proficient computer skills and knowledge of common office equipment.
• Ability to gain proficiency in Spectra Health's organizational software programs.
• Ability to organize and prioritize tasks.
• Ability to work under pressure and meet deadlines.
• Strong analytical, attention to detail, and problem-solving skills.
• Ability to work independently and as a member of a team.

Preferred:

• Bachelor's degree in Medical Billing/Coding, Business, or related field
• 2-3 years of experience in FQHC/healthcare billing
• 5+ years of healthcare experience

PHYSICAL REQUIREMENTS: The Billing Associate is primarily a desk job that requires the ability to sit for long periods of time (up to 8 hours) at a desk or workstation. Periodically the position requires lifting or carrying items that would be appropriate in an office environment, not more than 20lbs.

REMOTE WORK: The Billing Associate position is not eligible for full-time or hybrid remote work. For more information about remote work, please see HR Policy 1.28 - Remote Work. Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Spectra Health provides job opportunities, salaries and benefits, training, promotions, facilities, and other conditions of employment without discrimination based on race, color, national origin, religion, sex, age, disability, genetic information, or any other characteristic protected by federal or state laws. Spectra Health does not retaliate against applicants, employees, or former employees for filing a charge or complaint of
discrimination, participating in a discrimination investigation or lawsuit, or opposing discrimination.

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