Billing Support Specialist

Summary

Position Summary
Provides billing support for the Advanced Diagnostic Laboratories (ADx) at NJH. Responsible for coordinating and monitoring the flow of billing data within the clinical laboratory departments and other information system databases. Analyzes and evaluates clinical financial data, recognizes inconsistencies, and initiates the resolution of billing problems. Assists Client Services to immediately resolve billing inconsistencies and delinquent data. Implements billing plans designed to meet timely billing deadlines, and consult the Patient Financial Services (PFS) Department when applicable. Acts as liaison between ADx and the PFS Department to facilitate problem solving. Responsible for billing data, diagnosis, discharge and exception reports generated by the billing information systems to promote accurate financial billing.

Essential Duties

1. Establishes and maintains ADx financial policies and procedures. Ensures that ADx complies with all College of American Pathologists (CAP) and HIPAA requirements. 
2. Maintains clinical billing compliance for inpatient and outpatient (Client Accounts) with Medicare, Medicaid, Institutional Guarantors and other private insurances for accurate, successful reimbursement.
3. Performs database surveillance and maintenance for all billing applications and interfaces.  Maintains high standards of performance for operation of all Detailed Financial Transactions (DFTs).  Monitors billing interfaces.  Reconciles price and CPT changes for reference lab testing.
4. Investigates new and emerging CPT coding that will enhance the billing in the LIS including but not limited to DRGs, CPTs, 837 (Medicare exception report) and timely billing practices. 
5. Uses LIS and HIS auditing reports to verify the accuracy of patient and client billing.
6. Responsible for error reports (EXR/SIN/BR) and DFTs of clinical application system.  
7. Troubleshoots billing issues to a point of adequate resolution or until the issues are at least identified as to cause and effect. Troubleshoots all issues related to the patient billing interface, including coordination of late charges and establishing necessary accounts in the HIS.
8. Instructs users of the proper use of billing application programs including: Quick-OP Admits, Sunquest GUI, Manual Billing and Charge Master Verification.
9. Assists with the performance of a variety of client services issues when delinquent billing data is received. Including but not limited to Admitting, Discharging and Transferring (ADT) of patient data, Insurance (Third party billing), UPIN, EDI, NPI, SSN, Diagnosis and Guarantor entry.
10. Processes check and credit card payments using online system.
11. Performs product verification/validation and document outcomes of billing software and/or hardware changes or enhancements implemented. 
12. Moves charges when necessary to assure accurate billing derived out of the LIS and HIS.
13. Analyzes processes and applies critical thinking skills to the LIS and HIS and EMR systems. Serves as a backup to the LIS staff for new client accounts.
14. Clerical duties may include using printers, faxes, and sending mail, deliveries to on-campus locations, requisition scanning, handling phone calls, filing, archiving, labeling, sorting, and photocopying.

Other Duties
None

Competencies

1. Accountability: Accepts full responsibility for self and contribution as a team member; displays honesty and truthfulness; confronts problems quickly; displays a strong commitment to organizational success and inspires others to commit to goals; demonstrates a commitment to National Jewish Health. 
2. Attention to Detail: Accomplishing tasks by considering all areas involved, no matter how small; showing concern for all aspects of the job; accurately checking processes and tasks; being watchful over a period of time. Setting high standards of performance for self and others; assuming responsibility and accountability for successfully completing assignments or tasks; self-imposing standards of excellence rather than having standards imposed.
3. Collaboration/Teamwork: Cooperates with others to accomplish common goals; works with employees within and across his/her department to achieve shared goals; treats others with dignity and respect and maintains a friendly demeanor; values the contributions of others.
4. Informing and Communicating: Clearly conveying information and ideas through a variety of media to individuals or groups in a manner that engages the audience and helps them understand and retain the message.
5. Initiative: Taking prompt action to accomplish objectives; taking action to achieve goals beyond what is required; being proactive.
6. Impact and Influence: Using appropriate interpersonal styles and techniques to gain acceptance of ideas or plans; modifying one’s own behavior to accommodate tasks, situations, and individuals involved. Taking advantage of opportunities to make a difference and have an impact. When used well, the intended outcome of this competency is the creation of goodwill, trust, and respect while motivating people to want to follow you even when they don’t have to.

Supervisory or Managerial Responsibility
None

Travel
None

Core Values

1. Be available to work as scheduled and report to work on time.
2. Be willing to accept supervision and work well with others.
3. Be well groomed, appropriately for your role and wear ID Badge visibly.
4. Be in compliance with all departmental and institutional policies, the Employee Handbook, Code of Conduct and completes NetLearning by due date annually.
5. Fosters an inclusive workplace where diversity and individual differences are valued and leveraged to achieve the vision and mission of the institution.
6. Adheres to safe working practices and at all times follows all institutional and departmental safety policies and procedures. 
7. Wears appropriate PPE as outlined by the infection control policies and procedures.
8. Demonstrates compliance with all state, federal and all other regulatory agency requirements.

Minimum Qualifications

1. Education: High school diploma or GED required.
2. Work Experience: A minimum of 1 year of recent and related hospital, clerical, and medical insurance experience within a healthcare environment required.
3. Special Training, Certification or Licensure: None

Salary Range: $17.00 - $21.00

Benefits

At National Jewish Health, we recognize that our outstanding faculty and staff are the essence of our organization. For every aspect of health care, our employees are our greatest asset.

With that in mind, we have designed a valuable, comprehensive benefits package to meet the needs of our employees and their families.

• Medical Plans, Dental Plans and Vision Insurance
• Retirement Plan
• FSA and HSA
• Short and Long Term Disability
• Life Insurance and AD&D
• Voluntary Benefits, like Accident Insurance, Critical Care and Hospital Indemnity
• Sick and Vacation Paid Time Off
• Wellness Program
• Legal Plan