Billing Specialist

About Mosaic Community Health

Mosaic Community Health prides itself on being an innovative health system that pioneers unique and creative ways to provide and improve patient access to health care. Since our founding in 2002 we have proudly served insured and uninsured patients regardless of age, ethnicity, or income. We focus on a holistic approach to patient care by incorporating behavioral health, pharmacy, and nutrition support to serve patients in the most meaningful way. At Mosaic Community Health, you will work with incredibly dedicated and mission-centered peers and be part of a dynamic team based environment. Mosaic Community Health offers more than just a job, it is a lifestyle. A lifestyle of serving others. A lifestyle of being an integral part of your community. A lifestyle that offers work/life balance. A lifestyle of enjoying the outdoors! Central Oregon offers over 300 days of sunshine a year, so enjoy a PTO day on the mountain, biking/hiking trails, or the river! A lifestyle that improves lives, including yours. Of course, we also offer a great benefit package!

Opportunity

The Billing Specialist contributes to Mosaic’s Revenue Cycle by performing specific billing functions utilizing EPIC billing software and workflows. The Billing Specialist will post payments, review and research past due accounts, follow-up on unpaid claims as assigned to specified work queues, and make collection calls on unpaid accounts. This position is responsible for researching explanation of benefit (EOB) denials to assist patients with inquires on accounts.

Patient Account Duties

• Assist patient with sliding scale discount procedure, payment policies of the organization, understanding charges and payments to their accounts, by phone or in person.
• Recipient of patient inquiries regarding statement and billing questions.
• Identifies and resolves patient billing complaints.
• Posts payments to patient accounts from patient receipts and from insurance plans; proof, balance, close payment entry and file with the day’s transaction reports.
• Researches and follows up on unpaid claims and past due balances with third party payers when identified by patient inquires- primarily as it pertains to MVA, WC or other specialized accounts.
• Make collection calls to patients on past due accounts.
• Reviews accounts for possible assignment and prepares information for the collection agency.
• Using the computerized billing software as a tool, follow up on unpaid claims and patient accounts and perform necessary research and functions towards collection.

Claim Processing Duties

• Assist with eligibility verification with all payers.
• Assists providers as needed with charge entry questions.
• Using the computerized billing software as a tool, follow up on unpaid claims and patient accounts and perform necessary research and functions towards collection for those claims in the correctly identified work queues.
• Resolve claim and charge review errors.
• Recipient of insurance company and patient inquiries regarding statement and billing questions.
• Maintain positive working relationship with all staff in all departments and answer all revenue cycle questions from clinic staff.
• Maintain positive working relationships with the Billing Service.

Compliance

• Comply with all policies, procedures, guidelines, and workflows.
• Perform safe work practices to protect the health and safety of employees and patients per OSHA regulation.
• Protect individually identifiable health information per HIPAA regulation.
• Proper and timely documentation in EMR.
• Complete all required compliance training within the established timeline.
• Utilize the incident reporting system as needed.

Skills & Knowledge

• Knowledge of billing/collections, traditional health insurance plans, Medicare, Medicaid, and worker’s compensation.
• Knowledge of CPT and ICD9, ICD10 coding principles.
• Knowledge of third-party operating procedures and practices.
• Ability to understand documentation provided in patient chart related to charge entries and the concept of maximum reimbursement.
• Ability to use computerized patient management billing software.
• Understanding of Insurance Explanation of Benefits (EOB’s).
• Ability to research and take necessary action to collect on unpaid claims and patient accounts.
• Must possess basic math skills to balance EOB’s and batches.
• Skillful in the use of calculators, computers, spreadsheet software, word processing software, and excel.
• Prefer someone familiar with HIPAA.
• Excellent general office skills including use of fax, copier and phone system.