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Billing Specialist

Job ID: 2503013395-0 Date posted: 05/12/2025 Facility: BHS Physicians Network Houston

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Job Details

Description

Support billing and collections functions of the medical practice

2503013395

Enter charges in a timely manner.
File claims and run/work audit trails daily
Process ERAs, payments, and adjustments
Balance daily activity
Prepare and send Batch Cover Sheet to Director and accounting
Ensure that front office staff properly collects copays and balances due at time of service by auditing patient financial data up to 2 days before visit
Review/work delinquent insurance and patient balances Work credit balances
Run reports as requested by management or accounting

Include the following. Others may be assigned.

No.	Description	% of Time
	Bill primary claims appropriately completing the billing requirements via electronic submission or paper claims including any attachment of required documentation.	varies by site
	Properly submit claims to secondary and tertiary insurance companies with the appropriate Explanation of Benefits (EOB) attachments, if applicable.	varies by site
	Complete subsequent billing to third party payors to include rebills, secondary billing and/or special billing.	varies by site
	Fulfil paper billing payer requirements with submitting itemized statements, medical records and required forms to process the claim.	varies by site
	Review billing editor for all edits on UB04 and 1500 claim forms types related to charges, coding and patient information prior to billing to minimize underpayment, denials, and re-bill attempts.	varies by site
	Responsible for verifying correct insurance information is loaded into demographics using VI, account notes and related accounts as resources.	varies by site
	Responsible for routing accounts with needed updates for valid billing to the appropriate department or contact utilizing the workflow process.	varies by site
	Review the editor and/or control ID for all unbilled accounts and/or rebill requests.	varies by site
	Notate accounts with proper activity codes for workflow back to the facilities for review of unclean claims or to the appropriate department for next steps of claim workflow.	varies by site
	Bill all late charges with proper billing codes, per Late Charge Workflow.	varies by site
	Reviewing rejected claims to determine the cause and what the next appropriate steps are to resolve utilizing our available resources. Responsible for calling insurance company if rejection is unclear to determine next step needed for billing.	varies by site
	Flexibility in learning multiple systems and facilities as needed for billing inventory coverage.	varies by site
	Expectation to complete all assigned inventory daily provided by leadership, maintaining inventory and meeting production goals.	varies by site
	Maintain and abides by all billing policies and procedures, objectives, quality assurance programs and safety & compliance standards.	varies by site

FINANCIAL RESPONSIBILITY (Specify Revenue/Budget/Expense): N/A

SUPERVISORY RESPONSIBILITIES:

If direct report positions are listed below, the following responsibilities will be performed in accordance with guidelines, policies and procedures and applicable laws. Supervisory responsibilities include interviewing, hiring, and training employees; planning, assigning and directing work; appraising performance; rewarding and disciplining employees; addressing complaints and resolving problems.

Direct Reports (titles)	N/A
Indirect Reports (titles)	N/A

Qualifications for Internal Candidates

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Intermediate Microsoft Office (Word, Excel)
Good verbal and written communication skills.
Good data entry skills.
Able to work in a fast paced environment and complete high volume of claims daily handling multiple facilities

Conifer requires its candidates, as applicable and as permitted by law, to obtain and provide confirmation of all required vaccinations and screenings prior to the start of employment. This may include, but is not limited to, the COVID-19 vaccination, influenza vaccination, and/or any future required vaccines and screenings.

EDUCATION / EXPERIENCE

Include minimum education, technical training, and/or experience preferred to perform the job.

High School diploma or equivalent. Some college coursework in business administration or accounting preferred
1-2 years of experience in hospital billing or hospital collections required

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Ability to sit and work at a computer terminal for extended periods of time

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Office Work Environment

Qualifications

Education

Required: High school diploma/GED required

Preferred: Completion billing or coding program

Experience

Required: Must have a minimum of 2 years of experience working in medical billing

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Employment practices will not be influenced or affected by an applicant’s or employee’s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Tenet participates in the E-Verify program. Follow the link below for additional information.

E-Verify: http://www.uscis.gov/e-verify