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Senior Billing Specialist


Company

Lancaster General Hospital

Cost Center

7570 Pharmacy & IV Solutions

Supervisory Organization

Pharmacy & IV Solutions- Administration

Grade

G08

Summary

POSITION SUMMARY: Responsible for the billing, monitoring, and collection of accounts receivable in a timely manner.

ESSENTIAL FUNCTIONS: Qualified individuals must have the ability (with or without reasonable accommodation) to perform the following duties:

  • Responsible for all billing tasks associated with producing and submitting claims for all assigned payers including PPS payers.  Reviews claims for accuracy and completeness.  Ensures all claim submission tasks are completed at least twice per month. 
  • Proactive in problem-solving incomplete information to eliminate errors in the billing process and communicates information to the appropriate supervisor. Identifies problems that adversely impacts the billing process and communicates information to supervisor.
  • Reviews RFP file at least weekly and ADR file daily and completes appropriate follow-up as necessary as required for assigned payers.
  • Reviews all remittances and ensures payments are accurate.  Promptly researches and resolves any incorrect payments.
  • Maintains system for tracking outstanding accounts receivable bills.  Reviews outstanding claims on a regular basis and takes necessary steps to ensure collection.  Exhibits good judgment and adheres to Penn Medicine Home Health’s Every Time Behaviors while displaying excellent customer service during collection efforts.
  • Analyzes, assesses and corrects inconsistencies in accounts in a timely manner.  Documents accurately and thoroughly all collection activities.  Communicates problem accounts promptly to supervisor.
  • Assists department in maintaining Agency Days of Revenue in Accounts Receivable at a maximum of 75 days outstanding.
  • Completes and submits Credit Balance Report as required for assigned payers.
  • Maintains personal knowledge of current computer system as needed for effective accounts receivable management.
  • Maintains knowledge of current regulations and/or contracts as related to specific assignments.
  • Assists with the billing and collection of other payers as needed.
  • Maintains patient confidentiality in all transactions per regulations.
  • Follows all Agency policies and procedures, including participation in Penn Medicine Home Health quality improvement.

SECONDARY FUNCTIONS: The following duties are considered secondary to the primary duties listed above:

  • Establishes and maintains billing records in an organized manner.
  • Assists with training new staff on billing tasks.
  • ·Remains cross-trained with co-workers in department, understanding primary aspects of the department with 100% commitment to teamwork.

  • Responds to incoming telephone and mail inquiries promptly and courteously either verbally or through accurate written communication.
  • Produces accurate written communication utilizing appropriate office applications.
  • Other duties as assigned.

JOB REQUIREMENTS

MINIMUM REQUIRED QUALIFICATIONS:

  • Previous experience with computers.
  • Previous healthcare experience.
  • Proficient in operation of ten-key calculator.
  • High school diploma or equivalent required.
  • A health care provider in good standing with Medicare, Medicaid, and other federal and state health insurance programs, i.e. not excluded from participation in Medicare, Medicaid or any other federal or state health insurance program.

PREFERRED QUALIFICATIONS:

  • Minimum two (2) years prior medical billing experience in the home health field.
  • Minimum two (2) years’ experience in accounts receivable and collections, preferably in the medical field.
  • Associate degree in related field.

COGNITIVE REQUIREMENTS

Attention/Concentration: The following level of ability is essential for the jobholder to focus on certain aspects of current experience and reject others:

  • The position requires strong concentration skills.  The individual must have the ability to voluntarily sustain concentration to a task over an extended period of time as a result of an effortful and usually deliberate heightened and focused state of attention.

New Learning and Memory: The following level of ability is essential for the jobholder to learn and retain material:

  • The position requires that an individual be able to learn new tasks quickly and effectively.  Job requirements change frequently.  The ability to understand and carry out detailed, involved instructions in mandatory.

Problem Solving, Reasoning and Creative Thinking: The following level of ability that is essential for the jobholder to think (in order to solve a problem) by combining two or more elements from past experience or imaginative thought:

  • The position deals with issues or problems that often require thoughtful reasoning before arriving at approaches or solutions.  Some independent thought, planning or origination of options and solutions is necessary.  The individual must have the ability to apply principles of reasoning and problem solving to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.

TEMPERAMENTS:  The following are essential requirements of the position in relation to job-worker situations.  These items describe how a worker must adapt, adjust, conform or act:

Working within tolerances, set limits or standards: Ability to adapt to situations requiring the precise attainment of set limits, tolerances, or standards; to be precise, thorough, exacting, or meticulous in regard to material worked; or in activities such as numerical determinations, record preparation, or inspecting.

Variety and change: Ability to perform a variety of duties, often changing from one task to another of a different nature without loss of efficiency or composure involving significant differences in technologies, techniques, procedures, environmental factors, physical demands, or work situations.

Communication:  Ability to exchange information with others clearly and concisely; to present ideas, facts and technical information.

Planning and control: Ability to identify task requirements and monitor progress toward accomplishment.

Interpersonal relations: Ability to maintain relationships that facilitate task accomplishment; to cooperate and resolve conflicts; to recognize needs and be sensitive of others.

Language: Reading, Writing & Speaking:

  • Ability to read a variety of books, magazines, instructions, and encyclopedias.
  • Ability to prepare business letters, proposals, summaries, and reports; using prescribed format and conforming to all rules of punctuation, grammar, diction, and style; using all parts of speech.
  • Ability to communicate distinctly with appropriate pauses and emphasis; correct pronunciation (or sign equivalent) and variation in word order; using present, perfect, and future tenses.

Mathematics: The following levels of ability are necessary to understand mathematical concepts and apply them to problem-solving situations.

  • Ability to add and subtract two-digit numbers.
  • Ability to multiply and divide.
  • Ability to perform the four basic arithmetic operations with coins as part of a dollar.
  • Ability to add, subtract, multiply, and divide all units of measure.
  • Ability to perform the four operations with like or common decimal fractions. Ability to compute rate, ratio and percent.
  • Ability to perform arithmetic operations involving all American monetary units.

EQUIPMENT USAGE REQUIREMENTS: MACHINES, EQUIPMENT, TOOLS, SOFTWARE: To perform the essential duties of the position, use of the following machines, equipment, tools, and software is customarily required:

Machinery/Equipment: printer, telephone, calculator, personal computer, Dictaphone, modem, test equipment

Tools:   office supplies

Software:   Microsoft Office Products

PHYSICAL REQUIREMENTS: Degree of physical exertion is light, exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to move objects.

BODY POSITION AND MOVEMENT: The following positions or movements are typical of the job:

  • SITTING is done continuously.
  • WALKING is done occasionally.
  • STANDING is done occasionally.
  • CLIMBING is done seldom.
  • REACHING (Extending out and retrieving objects outside immediate range) is done seldom.
  • PUSHING (To press against something with substantial steady force in order to thrust forward, downward or outward) is done seldom.
  • PULLING (To exert a considerable force in order to draw, drag, haul or tug objects in a sustained motion) is done seldom.
  • LIFTING (To raise objects from a lower to a higher position or moving objects horizontally from position to position) is done occasionally.
  • END‑RANGE MOTION (To fully extend or retract a bodily part or joint to its maximum range in order to reach, push, pull, lift, or otherwise perform job functions) is done seldom.
  • STOOPING/CRAWLING (To lower the body to floor level, and move about with agility) is done seldom.

VISUAL REQUIREMENTS:  (Considerations include color, depth perception and field of vision).

  • The job requires a good sense of vision (with or without correction) necessary to distinguish like objects from one another, to scan fields of data and select numbers or characters, and/or to detect and visually follow moving objects.

AUDITORY (HEARING) REQUIREMENTS: Examples of the types of sounds that must be heard and the reason they must be heard are listed below:

SOUND                                 PURPOSE

voices                                     to converse, communicate

telephone ringing                 to answer incoming calls

WORKING CONDITIONS: Exposure to hazardous conditions/ materials is negligible.

Disclaimer: This job description is not intended and should not be construed to be an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job.  It is intended to be a reflection of those principal job elements essential for recruitment and selection, for making fair job evaluations, and for establishing performance standards.  The percentages of time spent performing job duties are estimates, and should not be considered absolute.  The incumbent shall perform all other functions and/or be cross-trained as shall be determined at the sole discretion of management, who has the right to amend, modify, or terminate this job in part or in whole.  Incumbent must be able to perform all job functions safely.

LGH Full Time Posted on 08/12/2019