(Basic skills and experiences necessary to perform the job: must be relevant, objective, and non-comparative)

§  High School Diploma or GED

§  Minimum of 2 years billing/collections experience in a medical group, health care company, or hospital setting.

§  Experience with various insurance plans offered by both government and commercial insurances (i.e. PPO, HMO, EPO, POS, Medicare, Medicaid, HRAs) and coordination of healthcare benefits, including requirements for referral, authorization and pre-determination.

§  Experience with reading and understanding the information provided on EOBs, remittance advices, and other insurance correspondence, and in calculating patient responsibility taking into consideration coverage and benefits, including referral, authorization, and/or pre-determination requirements, and contract terms.

§  Experience with medical billing and collections terminology – CPT, HCPCS, and ICD-9 coding.

§  Experience with HIPAA guidelines and healthcare compliance.

§  Experience with MS Office suite (Word, Excel, Outlook), and internet and web site navigation.

§  Experience with reviewing and analyzing insurance payments, and/or payor adjudication of claims against contract terms and patient coverage and benefits. 

(Skills and experiences beyond Basic Qualifications that help identify the best possible applicant)

§  Good customer service skills with ability to interact with both internal and external customers, i.e. patients, insurance payors, doctors, internal departments and handle in a professional manner with customer-friendly focus and attention to detail in resolving issues.

§  Proficiency in navigating multiple screens and programs at the same time in order to facilitate problem solving, and other activities that require multi-tasking.

§  Ability to maintain composure, and to follow instructions and protocols when dealing with unfamiliar or unusual payor / customer issues.

§  Demonstrated ability to present information in a clear, concise, and grammatically correct manner both verbally and in writing.

§  Demonstrated collaboration skills (including active listening skills, presentation skills) and proven ability to work effectively in a diverse, inclusive organization and environment.

§  Demonstrated ability to accept and carry out oral and written instructions accurately.

§  Demonstrated ability to prioritize work, handling daily and multiple tasks to completion within the time allotted, while working as part of a team within a demanding environment.

§  Ability to prepare forms, spreadsheets, and graphs. 

§  Experience in a payor or medical provider community that deal with all aspects of the revenue cycle.

§  Experience in a large corporate (even matrixed) environment

§  Previous work experience with GE Centricity

The physical demands described within the Responsibilities section of this job description are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job, the employee is regularly required to be independently mobile. The employee is also required to interact with a computer, and communicate with peers and co-workers.

While performing the duties of this job, the employee is regularly required to talk or hear, frequently required to sit and reach with hands and arms, and regularly required to stand; walk and use hands to finger, handle, or feel.

• Ability to sit, wear a headset, and work on the computer for extended periods of time. 
• Ability to lift 5 lb. ream of paper.

• Ability to work overtime as needed.