Billing Specialist in Portsmouth

Under general supervision, this position ensures all billings and payments are collected for services provided. Reports to the Reimbursement Supervisor.

Essential Job Functions

• Processes all identified insurance requirement edits and rejects to retransmit with corrected insurance information through the electronic billing system.
• Transmits all electronic claims directly to the insurance carriers, processes re-bills submitted to the billing department, and processes electronic insurance daily.
• Verifies that all electronic acknowledgements were received by the insurance carriers, verifies eligibility and authorizations, identifies and bills secondary or tertiary insurances, and submits required paper billing to insurance carrier on a daily/weekly basis.
• Follows up with insurance companies regarding any discrepancies in payments and on unpaid claims within standard billing cycle timeframe.
• Interprets Explanation of Benefits (EOBs) and verifies and ensures that all insurance payments are accurate and in compliance with contract discount.
• Performs administrative support work such as word processing, creating spreadsheets, data entry and retrieval, and functions that may require interpretation, judgment and determining appropriate processes to be used.
• Reviews forms, data and other information to ensure accuracy and conformance to established procedures and policies.
• Performs other related work as required.

Qualifications

• Requires an Associate’s Degree and 2 to 3 years of health insurance claims, billing and coding experience; or any equivalent combination of training and experience which provides the required education and experience.
• An acceptable general background check to include a local and state criminal history check and sex offender registry check.
• A valid driver’s license with an acceptable driving record.
• Individuals in this position cannot be listed as having a founded child abuse or neglect complaint.
• In the event of a declared emergency in the city of Portsmouth, individuals in this position are required to work shelter duty and may be called on to perform duties as required to provide for the safety and care of the citizens of the community.

Physical Requirements

• Must be physically able to operate a variety of automated office machinery and equipment including computer, printer, typewriter, calculator, facsimile machine, copier, multi-line telephone systems, etc.
• Must be able to exert up to 20 pounds of force occasionally, and/or up to 10 pounds of force frequently, and/or a negligible amount of force constantly to move objects.
• Physical demand requirements are in excess of those for sedentary work.

Interpersonal Communication

• Requires the ability to speak and/or signal people to convey or exchange information.
• Includes receiving instructions, assignments and/or directions from superiors.

Language Ability

• Requires the ability to read a variety of financial reports, billing forms and checks from third party payor, etc.
• Requires the ability to prepare financial interviews, cash turn-in reports, income verifications and client statements, etc., using prescribed formats and conforming to all rules of punctuation, grammar, diction and style.

Intelligence

• Requires the ability to apply common sense understanding to carry out instructions furnished in written, oral or diagrammatic form; to deal with problems involving several concrete variables in or from standardized situations.

Verbal Aptitude

• Requires the ability to record and deliver information, to explain procedures, to follow oral and written instructions.
• Must be able to communicate effectively and efficiently in Standard English and possess a basic working knowledge of accounting, clerical and computer operation terminology.

Numerical Aptitude

• Requires the ability to utilize mathematical formulas; to add and subtract totals; to multiply and divide; to determine percentages and decimals, to interpret graphs and to compute discounts, interest, profit and loss, ratio and proportion, etc.

Motor Coordination

• Requires the ability to coordinate hands and eyes rapidly and accurately in using automated office equipment.

Interpersonal Temperament

• Requires the ability to deal with people beyond giving and receiving instructions.
• Must be adaptable to performing under stress and when confronted with persons acting under stress.

AMERICANS WITH DISABILITIES ACT (ADA) REQUIREMENTS

The City of Portsmouth is an Equal Opportunity Employer. ADA requires the City to provide reasonable accommodations to qualified individuals with disabilities. Prospective and current employees are invited to discuss accommodations.