NHS Human Services, Inc.

Summary:

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.

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

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:

Associates of Science, 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.

Ab out Baystate Health

Baystate Health (BH) is one of New England’s leading and largest integrated health care organizations, serving a population of nearly one million people throughout western New England. With roots dating back to the founding of Springfield City Hospital in 1873, Baystate Health has been providing high-quality and compassionate health care in western Massachusetts for more than 145 years. With more than 12,000 employees, a medical staff of nearly 3,100 physicians, and a net patient service revenue of more than $1.4 billion, the ever-growing health system includes five Massachusetts hospitals and the Baystate Mary Lane Outpatient Center in Ware:

• Baystate Medical Center in Springfield

• Baystate Children’s Hospital (located at Baystate Medical Center)

• Baystate Franklin Medical Center in Greenfield

• Baystate Wing Hospital in Palmer

• Baystate Noble Hospital in Westfield