Community Health Systems
The Shared Services Center - Fort Smith provides business office support functions such as billing, insurance follow-up, customer service, scheduling and more for hospitals and healthcare providers.
Summary: The Billing Specialist I, under the direction of a Billing Manager, reviews and submits clean claims to primary, secondary and tertiary carriers for all facilities in which the Shared Services Center-Fort Smith provides service. This position maintains billing payer requirements for both Government and Non-Government payers.
Essential Duties and Responsibilities: (List in order of importance or percentage of time spent on the particular responsibility. High to Low)
- Review of insurance information, demographics, authorizations, charge adjustments and coding information for validity. (40%)
- Send requests to facility/internal to resolve barriers of clean claim submission and obtain required documentation needed for specific paper claim submission. (30%)
- Review insurance websites, contact payers and/or employers to ensure insurance information/authorizations/claim numbers are valid. (10%)
- Review of payer rejections and keying claims on websites. (10%)
- Proper noting of accounts and requests sent to facilities.(10%)
Required Education: High School Diploma or Equivalent
Required Experience: 1 year of experience in healthcare revenue cycle or business office
Preferred Experience: 1 year of experience in healthcare revenue cycle or business office focused including insurance medical billing
Required License/Registration/Certificate: None
Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of notes on account and responses from facilities and be able to make clear decisions when submitting claims.
To perform this job successfully, an individual should have knowledge of SSI, EDI Tracker, Insurance Websites, Host Systems (DAR/MedHost), Workflow tools (Artiva/CIQ) and Microsoft Processing software; Spreadsheet software and Database software.
In order to successfully perform this job, with or without a reasonable accommodation, the following are outlined below:
The Employee is required to read, review, prepare and analyze written data and figures, using a pc or similar and should possess visual acuity.
The Employee may be required to occasionally climb, push, stand, walk, reach, grasp, kneel, stoop, and/or perform repetitive motions.
The Employee is not substantially exposed to adverse environmental conditions and therefore job functions are typically performed under conditions such as those found in general office or administrative work.