Medical Billing Specialist

POSITION PURPOSE:

The position serves as a revenue management specialist and shall work collaboratively with other members of the department to successfully transmit to CMS required reporting including EDS and RAPS, manage the receipt of and posting of revenue, adjudicate incoming claims and process for payment.

Total Education, Vocational Training, and Experience –Three (3) to five (5) years of related job experience including Medicare / Medicaid billing and/or accounts payable experience. Proficient in Microsoft Office and electronics claims experience preferred

Skills and Abilities:

Exhibits tact, diplomacy, and team-player attitude working toward participant and facility-wide objectives;

Protects confidentiality in all areas as applicable;

Ability to appropriately track and transmit payments and claims data

Ability to demonstrate skill in administration, accountability, decision-making, and time management;

Ability to interact in a positive manner and communicate well with participant, families, co-workers, supervisor, and other PACE employees;

PROTECTED HEALTH INFORMATION:

Position has Full Access to Protected Health Information of PACE participants.

Proficiency or Productivity Standards:

Organize and prioritize tasks and projects

Accurately complete job responsibilities within the specified time constraints to meet the needs of participants, regulatory standards and customer satisfaction

Physical ReQUIREMENTS:

Essential functions:

Ability to speak, hear, and read English.

“Exceptional attendance is a requirement in order to fulfill role expectations.”

CRITICAL DEMANDS:

Lift up to 30# from floor to 36” and from 36” to 64” (Occasional)                         Sitting(Constant)

Walk up to .25 miles(Occasional)                                                                    Stand(Occasional)

Sustained forward bending in sitting(Occasional)                                         Repetitive Squat(Occasional)

Push/Pull up to 75#of force at 36”(Occasional)                                            Kneel(Occasional)

Repetitive Squat(Occasional)                                                                           Full body range of motion(Constant)

Grasp of various sizes and weights up to 50#(Constant)                            Sustained squat(Occasional)

Front Carry up to 30# for 25 feet(Occasional)

Balance(Continuous) In walking, standing, carrying, moving patients, and equipment, etc.

Working Conditions:

Patient rooms, common areas, clinical departments and PACE grounds. Potential hazards include:

MACHINES/EQUIPMENT USED

Office equipment such as computer, FAX, telephone, copier, calculator, etc.