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Job Req ID:  97378

Billing & Collection Specialist

Psychiatry Production Unit is seeking Billing & Collection Specialist who will be responsible for the collection of unpaid third-party claims and appeals, using various applications of JHM and JHU/ PBS billing applications. The Billing & Collection Specialist will work with payers to resolve issues and facilitate prompt payment of claims, follow-up with insurance companies to collect outstanding accounts of payments not received from assigned payor groups of outstanding patient accounts.


Specific Duties & Responsibilities

  • Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.
  • Gathers and verifies 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.
  • Applies appropriate discounts / courtesies based on department policy.
  • Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up matrix.
  • Prints and mails claim forms and statements according to the follow-up matrix.
  • Retrieves supporting documents (medical reports, authorizations, etc.) as needed and submits to third-party payers.
  • Appeals rejected/denied claims and claims with low reimbursement.
  • Confirm credit balances and gathers necessary documentation for processing refund.
  • Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issue causing non-payment of claims.
  • Contacts the payors or patient as appropriate for corrective action to resolve the issue and receive payment of claims. (By phone or use of payer websites).
  • Monitor invoice activity until problem is resolved.
  • Ensure claims submission requirements for all payors, expedite payments and appeal any rejections.
  • Understanding of Claims submission requirements for Mental Health claims.
  • Process daily mail, edits reports, file or pull EOB batches.
  • Identifies and informs the supervisor / Production Unit Manager of issues or problems associated with non-payment of claims.


Technical Knowledge

  • Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
  • Working knowledge of JHU/ PBS Billing Applications.
  • Utilize online resources to facilitate efficient claims processing.


Professional & Personal Development

  • Participate in on-going educational activities.
  • Assist in the training of staff.
  • Keep current of industry changes by reading assigned material on work related topics.
  • Complete three days of training annually.


Service Excellence

  • Must adhere to Service Excellence Standards.
  • Customer Relations.
  • Self-Management.
  • Teamwork.
  • Communications.
  • Ownership/Accountability.
  • Continuous Performance Improvement.


Minimum Qualifications
  • HS/GED required.
  • One-year experience in a medical billing or similar medical specialty environment required.
  • Additional education beyond minimum experience qualifications may substitute for required experience to the extent permitted by the JHU equivalency formula.


Preferred Qualifications
  • Comprehensive knowledge and compliance of HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).
  • Understanding of Epic registration process and ability to recognize and resolve insurance issues.
  • Working knowledge of JHU/ PBS Billing Applications.
  • Knowledge of insurance claims, CPT and diagnosis codes.
  • Utilize online resources to facilitate efficient claims processing.
  • Knowledge of medical terminology, CPT codes and diagnosis coding.
  • Excellent interpersonal, communication and customer service skills.
  • Ability to use various billing and patient information computer systems.
  • Knowledge of various payer processing and submission guidelines.

 


 

 

Classified Title: Billing & Collection Specialist    
Role/Level/Range: ATO 40/E/02/OC  
Starting Hourly Pay Rate Range: $15.00-$19.75 (Commensurate with experience)
Employee group: Full Time 
Schedule: M-F 8:30am-5:00pm 
Exempt Status: Non-Exempt 
Location: Hybrid/JH at White Marsh 
Department name: ​​​​​​​SOM Psy Production Unit  
Personnel area: School of Medicine 

 

Please refer to the job description above to see which forms of equivalency are permitted for this position. If permitted, equivalencies will follow these guidelines:


30 undergraduate degree credits (semester hours) or 18 graduate degree credits may substitute for one year of experience. Additional related experience may substitute for required education on the same basis. For jobs where equivalency is permitted, up to two years of non-related college course work may be applied towards the total minimum education/experience required for the respective job.

 

The successful candidate(s) for this position will be subject to a pre-employment background check.

 

The Johns Hopkins University values diversity, equity and inclusion and advances these through our key strategic framework, the JHU Roadmap on Diversity and Inclusion.

 

Equal Opportunity Employer

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

 

EEO is the Law
Learn more:
https://www.eeoc.gov/sites/default/files/migrated_files/employers/poster_screen_reader_optimized.pdf

 

Accommodation Information

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 Talent Acquisition Office at jhurecruitment@jhu.edu. For TTY users, call via Maryland Relay or dial 711. For more information about workplace accommodations or accessibility at Johns Hopkins University, please visit accessibility.jhu.edu.

 

Johns Hopkins has mandated COVID-19 and influenza vaccines, as applicable. Exceptions to the COVID and flu vaccine requirements may be provided to individuals for religious beliefs or medical reasons. Requests for an exception must be submitted to the JHU vaccination registry. For additional information, applicants for SOM positions should visit https://www.hopkinsmedicine.org/coronavirus/covid-19-vaccine/ and all other JHU applicants should visit https://covidinfo.jhu.edu/health-safety/covid-vaccination-information/.

 

The following additional provisions may apply, depending on campus. Your recruiter will advise accordingly.

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.

 

Note: Job Postings are updated daily and remain online until filled.

 

 

Hybrid