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Billing Specialist - URPG Billing

Job Description

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 Job Title: Billing Specialist - URPG Billing
 Company Name: United Regional Health Care System
 Employment Type: Full Time
 Location: WICHITA FALLS, TX, United States
 Salary: Highly Competitive
 Shift Hours/ Days: FT, 8AM-5PM Monday-Friday
 Hours/Pay Period: 80
 Degree Required: High School/GED
 Job ID: 2012-007127
 Date Posted: Dec 17, 2012
 Years Experience: unspecified
 Note:  Please read the complete description below before applying for this job.
  Complete Description

Summary of Essential Functions for the Position:

Verifies and computes insurance claims, payments, refunds, adjustments, benefits, patient balances and appeals.  Reviews and interprets billing regulatory issues and applies regulations in day to day billing practices. Coding of charges from the hospital notes, input information into a billing system, verifying accurate usage of CPT/ICD9 codes.  Prepares financial reports, productivity reports, graphs and worksheets. The duties of this position are not limited to the above and may be changed when necessary deemed.

Duties and Responsibilities:

  • Displays understanding of billing practices that are accurate and effective, to ensure compliance on regulatory issues.
  • Works outstanding governmental claims in aging of 150 and older and provides weekly report of findings to Manager.
  • Keeps current on NCCI rules and application of appropriate modifiers. Reviews Edits for billing staff and approves application appropriate changes as applicable.
  • Serves as backup to verify 24/72 hour rule is applied according to policy and Hospital reporting records. Ensures quarterly Credit Balance report is complete and accurate and is signed by CFO and submitted to Medicare within designated time frame. Serves as backup in absence of Reimbursement Specialist for all assigned daily reports and billing edits.
  • Reports unpaid delinquent claim findings to Director and reports on root causes for staff education and training .
  • Refilling of insurance claims as required from follow up on unpaid claims. Ensures follow-up for final receipt of reimbursement on problem accounts.
  • Compiles data to refile accurate insurance claims ensuring accuracy and identifying and correcting problems as well as reporting repetitious errors to Manager or Financial Analyst as applicable for education or system correction.
  • Timely processes assigned aged claims to ensure resolution of problem accounts. Ensures accurate adjustments, current financial class and filing or billing of next carrier when working assigned claims.

Educational Requirements:

High School Diploma or GED required.  Must be able to communicate effectively in English both verbally and in writing. Over 2 years and up to 4 years recent billing experience, all of which may be obtained through vocational school or related job experience.


Knowledgeable of HCFA and other regulatory billing requirements.  Ability to use personal computer, including but not limited to Microsoft office and lotus notes.  Ability to organize, make independent decisions, instruct, listen, display professionalism and adhere to confidentiality for employees and patients.  Knowledge of revenue codes, HCPCS codes, CPT codes, ICD9 codes and local codes.  Ability to apply NCCI and OCE edits in daily processes of the department.

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