Billing and Collection Specialist
Role/Level/Range: ATO 40/E/02/OC
Starting Salary Range: $13.23 - $18.23
Employee group: Full Time
Schedule: M-F 8:30 am - 5:00 pm
Exempt Status: Non-Exempt
Location: 16-MD:JH at White Marsh
Department name: 10003403-SOM Neuro Production Unit Billing
Personnel area: School of Medicine
Will be responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU/ PBS billing applications.
Specific duties & responsibilities:
- Work with payers to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts for which payment has not been received in response to the claims submission process, either electronically or by paper.
- The Specialist will be assigned pay or groups of outstanding patient accounts.
- Various methods of follow-up will be used including all JHU/ PBS Billing Applications.
- Use NR follow-up systems and reports to identify unpaid claims for collection/appeal. Gather and verify all information required to produce a clean claim including special billing procedures that may be defined by a payer or contract.
- Review and update patient registration information (demographic and insurance) as needed.
- Apply appropriate discounts I courtesies based on department policy.
- Prepare delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
- Print and mail claim forms and statements according to the follow-up matrix. Retrieve supporting documents (medical reports, authorizations, etc) as needed and submits to third-party payers.
- Appeal reflected claims and claims with low reimbursement.
- Confirm credit balances and gathers necessary documentation for processing refund. Identify insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
- Contact the payers or patient as appropriate for corrective action to resolve the issue and receive payment of claims. Monitor invoice activity until problem is resolved.
- Process daily mail, edit reports, file or pull EOB batches. Identify and inform the supervisor I Production Unit Manager of issues or problems associated with non-payment of claims.
- Perform other duties as required.
Minimum qualifications (mandatory):
- High School Diploma or GED required.
- One year experience in a medical billing or similar environment required.
- Knowledge of medical terminology, CPT codes and diagnosis coding required.
- Additional education beyond minimum experience qualifications may substitute for required experience to the extent permitted by the JHU equivalency formula.
Special knowledge, skills, and abilities:
- Excellent Interpersonal, communication and customer service skills
The successful candidate(s) for this position will be subject to a pre-employment background check.
If you are interested in applying for employment with The Johns Hopkins University and require special assistance or accommodation during any part of the pre-employment process, please contact the HR Business Services Office at email@example.com. For TTY users, call via Maryland Relay or dial 711.
The following additional provisions may apply depending on which campus you will work. Your recruiter will advise accordingly.
During the Influenza ("the flu") season, as a condition of employment, The Johns Hopkins Institutions require all employees who provide ongoing services to patients or work in patient care or clinical care areas to have an annual influenza vaccination or possess an approved medical or religious exception. Failure to meet this requirement may result in termination of employment.
The pre-employment physical for positions in clinical areas, laboratories, working with research subjects, or involving community contact requires documentation of immune status against Rubella (German measles), Rubeola (Measles), Mumps, Varicella (chickenpox), Hepatitis B and documentation of having received the Tdap (Tetanus, diphtheria, pertussis) vaccination. This may include documentation of having two (2) MMR vaccines; two (2) Varicella vaccines; or antibody status to these diseases from laboratory testing. Blood tests for immunities to these diseases are ordinarily included in the pre-employment physical exam except for those employees who provide results of blood tests or immunization documentation from their own health care providers. Any vaccinations required for these diseases will be given at no cost in our Occupational Health office.
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