• Sr. Prof Billing Specialist - Rev Cycl _Prof…

    Queen's Health System (Honolulu, HI)


    RESPONSIBILITIES

    I. JOB SUMMARY/RESPONSIBILITIES:

    • Provides work leadership and technical guidance to the Professional Billing Specialists.

    • Monitors work assignments to ensure accurate and timely billing of patient accounts, claims submissions and follow up on denied claims in accordance with policies and procedures of The Queen’s Health Systems (QHS) and The Queen’s Medical Center (QMC) and in compliance with federal, state, insurance carriers, health plans and other third party payor requirements.

    • Identifies and recommends opportunities for process improvement.

    • Supports management with special projects as assigned.

    • Performs duties of a Professional Billing Specialist as needed.

    II. TYPICAL PHYSICAL DEMANDS:

    • Essential: sitting, stooping/bending, finger dexterity, seeing, hearing, speaking, lifting, and carrying usual weight of 5 pounds, repetitive arm/hand motions, static gripping of an object for prolonged periods, frequent gripping of an object.

    • Occasional: standing, walking, kneeling, climbing stairs, squatting, twisting body, lifting weight up to 10 pounds, pushing/pulling usual weight of 2 pounds up to 5 pounds, reaching above, at and below shoulder level.

    • Operates computer, printer, copier, calculator, and telephone.

    III. TYPICAL WORKING CONDITIONS:

    • Not substantially subjected to adverse environmental conditions.

    IV. MINIMUM QUALIFICATIONS:

    A. EDUCATION/CERTIFICATION AND LICENSURE:

    • High School diploma or equivalent education.

    • Associate’s or Bachelor’s degree in business, finance, accounting, healthcare or related field preferred.

    • Current certification in billing preferred.

    B. EXPERIENCE:

    • Three (3) years recent experience in medical insurance claims, processing, billing, denials and follow up, preferably in a large group practice or acute care facility.

    • Experience to demonstrate the following:

    o Knowledge of Medicare, Medicaid and third party requirements.

    o Prior supervisory/leadership experience and/or demonstrated knowledge and background to lead staff.

    o Ability to communicate effectively in English, both orally and in writing.

    o Experience with computer based applications, preferably in SMS and/or EPIC systems.

    • Experience with analysis and reporting preferred.

     

    Equal Opportunity Employer/Disability/Vet