Reports directly to Practice Leadership as designated by the Director. May receive directions from the Practice Supervisor, Practice Manager, and other members of the Service Line/Department leadership team. The Ambulatory Billing Specialist acts as a liaison between the Physicians' Billing Office/ Hospital Revenue Cycle teams and physicians and their staff; communicates concerns with internal and external management. Responsible for regional and/or high complexity billing charge capture. Coordinates staff and providers in the department to ensure billing charge capture for all assigned locations. The incumbent is also responsible for identifying and rectifying all outstanding charge issues to ensure claims are billed timely and accurately.
Job Responsibilities:
1) Captures billing charges for all assigned locations
Assembles analyzes and batches charges accurately in a timely manner. Follows ICD-10 and CPT guidelines and codes diagnoses and procedures as required. Sends thorough charges and adjuncts (referrals, reports, etc.) to the PBO within the allowable timeframe.
2) Acts as a liaison between physicians in the Department of Baystate Reproductive medicine, their staff, 3300 Main St, Biology Lab, and the Physicians' Billing Office.
Informs the PBO of billing issues within the Department and follows up in a courteous and professional manner. Guides and assists clerical staff with billing and insurance concerns as necessary or directed. Reports accurate end of the month statistics to physicians and administrative staff. Attends meetings and seminars as required or directed.
3) Maintains accurate up-to-date purveyor files.
Information is posted and verified into records and logs with accuracy. Files copies of charges, HMO membership listings, and other miscellaneous documents in correct order and sequence to allow for easy access.
4) Accurately deletes old codes and replaces with new ones in accordance with CPT and ICD-10 guidelines Complete forms and sends changes/corrections to proper personnel and departments (Information Systems, Budget Dept., Medical Records, Patient Accounting, and the PBO. Manages correct input of fees into Patient Keeper. Manages IVF spreadsheet on the S drive.
5) Sends miscellaneous mailings.
Sends out billings for outside agencies (grants, contracts, lawyers, etc. if applicable).
Sends out letters and memorandums as necessary or directed.
6) Follows up on daily telephone calls and correspondence related to billing, insurance and prior auths.
Seeks out resolutions for all incoming billing inquiries from patients, provides support and financial guidance and follows up appropriately. Deposits checks received accurately in accordance with the chart of accounts.
7) In absence of Department Secretary, receives and screens visitors and telephone calls for the department.
Greets and receives visitors in a courteous and professional manner. Screens visitors and promptly notifies appropriate personnel when required. Provides information and answers inquiries in accordance with established department procedures. Screens incoming calls and routes to appropriate personnel or takes an accurate messages in accordance with established department procedures.
8) General Service Excellence Principles.
Identifies the key elements of service excellence. Able to successfully deal with challenging day to day interactions with patients, families, visitors, and customers in a consistent manner i.e., physicians, staff, etc. Consistently uses service excellence behaviors as evidenced by no reasonable patient complaints received from patients, families, and/or providers. Identifies and respects the needs of the internal and external customers. Maintains the patient's/customers' sense of self-worth and dignity in difficult situations. Maintains a calm, controlled approach at all times. Consistently projects an image of Baystate's services and systems in a positive manner.
9) Patient/Customer First.
Communicates to patients/customers that they are a high priority even during busy times. Treats patient's information confidentially. Shows patients/customers that she/he believes that they are important. Shows sensitivity to the patients'/customers' non-verbal communication. Maintains the patient's/customers' sense of self-worth and dignity in difficult situations. Facilitates Access to services.
10) Judgment and Empathy
Identifies the patients/family's members of customer's needs. Assesses the potential impact on the patient/customer when making a decision. Develops alternatives when the best course of action is not available. Acknowledges what the patient and customer has said. Summarizes and demonstrates that he/she has listened to the patient/customer. Empathizes with the patient/customer. Identifies resources. Uses body language such as eye contact, smiling, etc. to demonstrate interest.
Education Requirements:
High School diploma or GED
Required Work Experience:
1) 1 - 2 years
Preferred Work Experience:
1) Yes with medical terminology
Skills and Competencies:
1) Knowledge of third party insurance regulations
2) Word processing and spreadsheet skills
3) Excellent customer relations skills
DEPARTMENT DESCRIPTION:
Multi-Disciplinary Outpatient Rehabilitation practice servicing Western MA for over 15 years.
Gain Experience in the healthcare industry to include patient registration, scheduling, insurance authorization and billing.
Collaborative work environment provides a positive patient and employee experience and is demonstrated through high patient satisfaction and employee engagement scores.
HOURS:
Working hours are M-F 8am to 4:30pm
Flexibility is required for training hours. Candidate may have to occasionally train 10:30am to 7pm shift.
THE ADVANTAGES OF WORKING WITH BAYSTATE!
Excellent Compensation High-quality, low-cost medical, dental and vision insurance
Generous PTO - up to 25 days in the first year, with scheduled earned increases
Continuing education support and reimbursement
First Time Home Buyers Financial Packages
Farm Share Memberships
403b retirement company match & annual company contribution increase based on years of service
Free money coach advice from a certified professional
Wellbeing programs that include but are not limited to mental, physical, and financial health
Pet, home, auto and personal insurance
Life insurance
Reimbursement for a variety of wellbeing activities, included but limited to gym membership and equipment, personal trainer, massage and so much more!
Wellbeing programs that include but are not limited to mental, physical, and financial health
Baystate Health, western Massachusetts' only academic center and tertiary care provider has a long and proud tradition of continuous learning and improvement. We educate and train hundreds of healthcare workers every year and advance knowledge about new approaches to care. At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. We are committed to increasing diverse representation across our organization. Together our inspired and compassionate teams manage the whole health needs of all communities in need.
We strive to be the place where we can help you build the career you deserve - apply today - YOU belong at Baystate!
OUR COMPENSATION PHILOSOPHY
We offer competitive total compensation that includes pay, benefits, and other recognition programs for our employees. The base pay range shown above considers the wide range of factors that are considered in making compensation decisions including knowledge/skills; relevant experience and training; education/certifications/licensure; and other business and organizational factors. This base pay range does not include our comprehensive benefits package and any incentive payments that may be applicable to this role.
You Belong At Baystate
At Baystate Health we know that treating one another with dignity and equity is what elevates respect for our patients and staff. It makes us not just an organization, but also a community where you belong. It is how we advance the care and enhance the lives of all people.
DIVERSE TEAMS. DIVERSE PATIENTS. DIVERSE LOCATIONS.
Education:
GED or HiSET (Required)
Certifications:
Equal Employment Opportunity Employer
Baystate Health is an Equal Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, marital status, national origin, ancestry, age, genetic information, disability, or protected veteran status.
