Billing Specialist

The Billing Specialist is responsible for collecting, posting, and managing account payments. Additionally, they are responsible for submitting claims and following up with insurance companies.

Essential Functions:

The functions performed by employees in this job family will vary by level or the area(s) to which assigned but may include (and not be limited to) the following. Employee must perform all duties and responsibilities in accordance with Via Care’s care standards.

• Prepares and submits clean claims to various insurance companies’ either electronically or by paper.
• Answers questions from patients, clerical staff, and insurance companies.
• Identifies and resolves patient billing complaints.
• Prepares, reviews, and sends patient statements.
• Evaluates patient’s financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
• Reviews accounts for possible assignment and makes recommendations to the Billing Supervisor, also prepares information for the collection agency.
• Performs daily backups on office computer system.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Processes payments from insurance companies and prepares a daily deposit.
• Participates in educational activities and attends monthly staff meetings.
• Conducts self in accordance with HPA’s employee manual.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Knowledge, Skills, and Abilities:

• Knowledge of medical billing/collection practices.
• Knowledge of computer programs.
• Knowledge of business office procedures.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Ability to operate a computer and basic office equipment.
• Ability to operate a multi-line telephone system.
• Skill in answering a telephone in a pleasant and helpful manner.
• Ability to read, understand and follow oral and written instructions.
• Ability to establish and maintain effective working relationships with patients, employees, and the public.
• Must be well organized and detail oriented.

Special Requirements:

• Must have a reliable automobile for use on the job.
• Education: High School Diploma or GED.
• Subject to a criminal background check prior to employment.
• Must possess valid California Driver License.
• Must have and maintain State required automobile insurance coverage.
• TB and post-employment physical clearance, to be renewed every year.