Department: Health Services Reports To: Billing Manager FLSA: Non-Exempt

Effective Date: March 2009 Approved By: Chief Financial Officer

POSITION SUMMARY

The Billing Specialist to serve as a clinical resource person for all Patient Business Services. The Billing Specialist will assure that the provision of high quality; cost efficient, culturally sensitive services comply with all Federal, State and Local agency policies and procedures.

PRINCIPAL DUTIES AND RESPONSIBILITIES

I. Essential Functions

1. Prepares and submit clean claims to various insurance companies either electronically or by paper.
2. Answers questions from patients, clerical staff and insurance companies.
3. Identifies and resolves patient billing complaints.
4. Prepares, reviews, and sends patient statements.
5. Evaluates patient financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
6. Reviews accounts for possible assignment and makes recommendations to the Billing Manager, also prepares information for the collection agency.
7. Performs daily backup on office computer system and performs weekly shutdown of systems.
8. Performs various collection action including contacting patients by phone and correcting and resubmitting claims to third party payers.
9. Processes payments from insurance companies and prepares a daily deposit.
10. Participates in educational activities and attends monthly staff meetings.
11. Conduct self in accordance with CCI’s employee manual.
12. Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.

Requirements: Specific Job Skills

Requires advanced ability to read, write, speak and understand English/Spanish. Work requires continuously using problem analysis, decision making, and independent judgment, the use of discretion, creativity, mentoring, counseling, teamwork, interpersonal skills, presentation skills, and evaluation skills. Professional nursing skills including an advanced skill in charting efficiencies and requirements is necessary. The physical ability to stand for long periods of time, talk, listen, write, and sit intermittently is required. Work requires occasional bending and stooping. Must be able to occasionally lift, push and/or move 25 pounds, operate a computer including keyboard, multi-line phone and occasionally work in excess of 8 hours per day or 40 hours/week.

Required Knowledge, Experience or Licensure/Registration

1. Knowledge of medical billing/collection practices
2. Knowledge of computer programs.