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Insurance Billing Specialist - RAP Job


Summary

Collects more complex patient accounts from third party payers and patients to maximize cash receipts and minimize receivables while maintaining effective customer relations. Works under minimal supervision and may adapt procedures, processes, and techniques to meet the more complex requirements of the position. Models appropriate behavior as exemplified in MLH Mission, Vision and Values.

Education/Experience/Licensure

 

Education/Formal Training

Work Experience

Credential/Licensure

 

REQUIRED:

High school graduate or equivalent.

Minimum of six months of previous hospital billing/follow-up experience required.

N/A

 

PREFERRED:

 

N/A

 

N/A

 

N/A

 

SUBSTITUTIONS ALLOWED:

 

N/A

 

If lieu of the six months of experience, the candidate must have completed a 90 day externship program at MLH.

 

 

N/A

Knowledge/Skills/Abilities

  • Intermediate motor abilities for the operation of calculator, typewriter, and computer terminal.  Accuracy is essential.
  • Moderate mathematical proficiency required to include addition, subtraction, multiplication, and calculation of percentages.  Accuracy is essential.
  • Strong verbal and written communication skills. 
  • Ability to apply problem-solving techniques.
  • High degree of assertiveness and determination required.

Key Job Responsibilities

  • Reviews and edits more complex and non-routine claims.  Identifies and communicates problems regarding claims.  Maintains pending claims at minimal levels.
  • Analyzes more complex accounts for collectibility purposes.
  • Reviews, follows up, and collects payment of claims on more complex accounts.
  • Reviews and issues insurance bills.  Reviews account related correspondence.
  • Determines resolution of credit balances.
  • Assists Lead and Supervisor with training/orienting and provides guidance to lower level staff members.
  • Performs other job functions as assigned.

Physical Requirements

  • The physical activities of this position may include climbing, pushing, standing, hearing, walking, reaching, grasping, kneeling, stooping, and repetitive motion.
  • Must have good balance and coordination.
  • The physical requirements of this position are: light work - exerting up to 25 lbs. of force occasionally and/or up to 10 lbs. of force frequently.
  • The Associate is required to have close visual acuity to perform an activity, such as preparing and analyzing data and figures; transcribing; viewing a computer terminal; or extensive reading.
  • The conditions to which the Associate will be subject in this position: The Associate is not substantially exposed to adverse environmental conditions; job functions are typically performed under conditions such as those found in general office or administrative work.