Job Information
CareOregon Billing Specialist in Portland, Oregon
Housecall Providers www.housecallproviders.org
Housecall Providers is a Portland area nonprofit organization and one of the largest providers of medical care exclusively in the home in the Western United States. We are proving every day that in home medical services for homebound and chronically ill patients can improve health outcomes, increase patient comfort, reduce health care costs and increase provider satisfaction. We are a proud part of the CareOregon family of health organizations.
Our Mission
Improving lives by bringing health care home.
Our Vision
To sustainably transform home-based medicine so all homebound adults and those living with serious illness have access to care that improves their quality of life.
Our Values
Compassion and respect, authentic relationships, collaboration, courage, social justice.
Diversity Statement
We embrace the diversity of our employees, patients, and those who care for them. Through awareness and advocacy, we are working to create health equity by recognizing and reducing barriers that affect non-dominant groups within Housecall Providers and our communities at large.
The quadruple aim is real at Housecall Providers
In home medical care for homebound patients is proven to increase patient comfort, improve health outcomes, reduce health care costs and increase provider/care team satisfaction. Housecall Providers has saved Medicare millions of dollars, while providing better care to our patients, ensuring greater patient comfort, improved health outcomes and care team satisfaction. With the population aging, more people are suffering from multiple chronic conditions and degenerative diseases. This trend will continue as roughly 10,000 baby boomers a day enter the Medicare system.
Job Title
Billing Specialist
Department
HCP-Primary Care
Exemption Status
Non-Exempt
Requisition #
24563
Direct Reports
N/A
Manager Title
SR Revenue Cycle and Financial Manager
Pay & Benefits
Estimated hiring range $46,540 - $56,880/year, 5% bonus target, full benefits.
www.careoregon.org/about-us/careers/benefits
Posting Notes
This is a hybrid position with 1-2 days per month in the office
Job Summary
The Billing Specialist ensures that claims are billed accurately on a timely basis. This position ensures that appropriate follow-up and collection actions are taken to maintain a low percentage of accounts receivable (under 10%). This includes setting up patient financial arrangements as needed. The Billing Specialist also answers patient inquiries and works to resolve billing problems or escalates complex issues as needed.
Essential Responsibilities
Verify Contracted Insurance for Primary Care Patients, prior to admission, including verification we are listed as PCP for all contracts that require it.
Follow up with patients whose insurance has changed to a non-contracted Insurance company, and with patients whose insurance has terminated.
Enters diagnosis and procedure codes efficiently and accurately.
Reviews and corrects denied claims and re-bill for payment and/or call insurance company as necessary to resolve the claim.
Resolves billing questions when patient and/or family members call in – updates information accordingly as needed.
Submits charges electronically to insurance companies and uploads electronic remittances routinely as directed by the Operations and Billing Manager.
Responds to insurance payer requests for information in a prompt and professional manner.
Ensures final statements are going to a POA, guardian or guarantor for deceased patients, so that final billing can be paid; contacts probate if needed to see if patients have estates.
Verifies addresses on all returned mail.
Performs audits on patient accounts to ensure accuracy and timely payment by following up with insurance companies or patients as necessary.
Verifies from Revenue Cycle and Finance Manager if patient accounts should be written off.
Performs reconciliation of refund accounts, attaches documentation, and forwards for processing.
Communicates effectively with patients, family members, and insurance companies regarding sensitive financial matters and recapture unpaid balances.
Identifies problems on accounts and follows through to conclusion or seeks assistance.
Maintains confidentiality regarding all patient and clinic information.
Attends billing PIP meetings, webinars, and other staff meetings when scheduled.
Utilizes current billing information and resources provided.
Posts payments to patient accounts according to protocol in an accurate and efficient manner.
Reconciles and balances each payment batch.
Works with AR staff to ensure all payments are reconciled and entered into the billing/payment module.
Provides cross coverage and back-up support by assisting with the following duties:
Entering hospice information for new hospice patients into primary care EHR and patient management if updating is required; contacting outside hospice agencies to verify the start date, diagnosis, and confirm the attending provider.
Billing secondary claims on HCFA 1500 forms after payments posted for primary payers, by attaching the primary EOB’s and mail; verifying if Medicaid is secondary/tertiary, then take appropriate billing action as directed by the Operations and Billing Manager.
Taking and processing payments over the phone for Visa or MC.
Essential Department Functions
Provide back up for reception which includes answering and routing phone calls, greeting and directing visitors.
Maintain patient/family and staff confidentiality in compliance with HIPAA laws.
Maintain agreed upon work schedule and meet deadlines for completion of work.
Serve as an ambassador for CareOregon and Housecall Providers at all times.
Demonstrates cooperation and teamwork and maintains collaborative relationships with all levels of staff and community partners.
Participate in orientation of new employees, volunteers or students seeking experience, as requested.
Attend staff and mandatory in-services meetings, as required.
Participate in ongoing education and assume responsibility for updating professional skills.
Organizational Responsibilities
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.
Experience and/or Education
Required
Minimum 2 years’ experience working in a medical office or other related healthcare agency in with direct experience or exposure to billing processes.
Previous experience working with an electronic health record system
Preferred
Certificate in medical billing/coding
Knowledge, Skills and Abilities Required
Knowledge
Familiarity with current medical billing, terminology, and coding requirements
Skills and Abilities
Accurate and efficient
Ability to stay focused and demonstrate strong organizational skills
Ability to interact professionally and pleasantly with staff, patients, families, caregivers and the general public
Effective computer skills, including working knowledge of Microsoft Office system
Growing understanding of electronic medical record systems and the ability to integrate updates to those workflows on a regular basis
Strong customer service skills, including the ability to interact professionally, patiently, and courteously with customers over the phone and in person
Ability to work both independently and collaboratively
Ability to work under pressure to meet deadlines
Ability to take initiative and learn new techniques and processes.
Ability to interact with various departments throughout the organization
Ability to work flexible hours, if needed
Ability to use good judgment, personal initiative and discretion to perform job responsibilities
Team oriented, collaborative, and open to constructive feedback
Ability to adhere to organizational standards, policies and procedures
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
Ability to hear and speak clearly for at least 3-6 hours/day
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.Equipment: General office equipment
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
#LI-Hybrid
Candidates of color are strongly encouraged to apply. CareOregon is committed to building a linguistically and culturally diverse and inclusive work environment.
Veterans are strongly encouraged to apply.
We are an equal opportunity employer. CareOregon considers all candidates regardless of race, color, religion, sex, sexual orientation, gender identity, national origin, age, genetic information, disability, or veteran status.
Visa sponsorship is not available at this time.