1000+ Best high school Jobs in San Antonio, Texas (December 2025) - page 10

Billing & Collections Specialist

11 days ago

San Antonio

Business Office Billing & Collections Specialist Knowledge Skills & Abilities: The Business Office employee under the supervision of the Business Office Director and Business Office Supervisor is responsible for the financial success of the facility as it relates to revenue cycle management. The employee should have a full understanding of each of the processes to maximize reimbursement: collections of all payer types billing and revenue coding insurance benefit interpretation authorization admission sources payer specific requirements contract reimbursement claim editing clearinghouse processing adjudication and appeals/denial management. It is understood that business office clerks will change tasks from time to time to meet the needs of the business. Behaviors/Abilities Projects a professional demeanor and appearance while maintaining the confidentiality of patients co-workers and the surgery center and adhering to the HIPAA policy. Reports in good faith any known or suspected activity that appears to violate laws rules regulations or the SP Code of Conduct. Fulfills annual Competency continuing education requirements. Personal attributes include the ability to be self-directed; demonstrates accountability professionalism and receptiveness to change; seeks guidance direction and assistance when needed. Works under stress and in situations that demand patience stamina endurance and tact while providing impeccable service. Fosters an attitude of teamwork and willingness to assist others and does not refuse performing other job duties as requested within the hospital or hospital outpatient department. Sets priorities responds timely to issues which require a decision and ensure desired results are achieved by means of consistent follow through. Willingly accepts other assignments as the need arises. PEOPLE • Assigned tasks to be completed accurately and within specified timelines., • Assures Annual competency education is up to date and completed prior to deadlines., • Participates in regular departmental staff meetings and facility-wide meetings., • Always on time for work and attendance is within company policy guidelines, • Willingness to assist in orientation of new staff and ensuring a high level of employee satisfaction and retention., • Performance self-evaluations to be completed and returned before scheduled date for annual performance review., • Performs and conducts self in a professional and appropriate manner in all situations, • Demonstrates respect and cooperation in all staff relationships and a genuine willingness to prevent or resolve inter-personal conflicts., • Demonstrates the ability to participate in and/or implement team decisions., • Ensures accurate appropriate and timely billing for facility claims of admission of various admission types payers and locations., • Completes claim audit for correct billing/coding/authorization prior to claim submission, • Completes required claim data fields and edits to ensure clean claim submission, • Complete claim batch processing through database and claims clearinghouse, • Review database edits and claim holds for resolution, • Monitors clearinghouse claims processing daily for claims management, • Monitors payer websites for claims status and billing updates, • Interprets payer contracts to ensure payments received is in line with expected reimbursement, • Capable of adjudication and analysis of claims processing based on payer explanation of benefits, • Performs daily financial review of accounts receivable for reimbursement, • Addresses payer denials timely and submits required appeals, • Processes payer correspondence and appropriately addresses requests, • Communicates with other departments/provider offices as it pertains to resolution of reimbursement for collection, • Completes required billing/collection reports as assigned by management, • Assist with timely month end billing/collection processes, • Addresses payer issues with patients when related to billing & charge issues coordination of benefits third-party liability injury PIP denials non-coverage etc., • Makes required corrections to patient demographic for claims processing, • Ensures retention of billing/collection documentation is maintained in shared drives/location, • Enters communication documentation in database regularly, • Informs management of all extraordinary situations encountered related to billing/collections., • Maintains scanned copies of all pertinent financial clearance documentation within the EHR., • Consistently uses facility approved translation system for proper patient communication when a translator is required. Documenting translation validation appropriately., • Performs other duties as assigned, • Demonstrates competence to perform assigned and general customer assistance responsibilities in a manner that meets the age-specific and developmental needs of customers encountered. SERVICE • Develops and maintains a culture of service in department connecting organizational values to actions., • Utilizes every opportunity to improve the patients understanding of financial responsibility., • Assures the department provides a high level of Patient Satisfaction through interactions discussions and recognition of team members., • Assures a high level of Physician Satisfaction with responsible departments models interactions with physicians to managers and staff and participates in development and implementation of action plan as needed for improvement., • Assures that business office systems are in place to maintain compliance with State Federal and accreditation standards., • Complies with departmental policies and procedures to meet regulatory and community standards., • Ensures accurate and complete billing and collections processing and works to maintain departmental quality goals., • Collection of expected reimbursement as per payer contract, • Maintains workflow of billing and collections processing and communicates issues to management when required action is needed., • Provides prompt and professional phone courtesy while answering phone calls, • Manages collection activities to maximize revenue to assure budgeted EBITDA results are achieved., • Ensures claims processing accuracy meets department goals to promote timely and accurate billing and reimbursement, • Account management is performed according to SP benchmarks and guidelines, • Actively participates in achieving the monthly collection goals. Communicates with patients as necessary to discuss financial responsibility, • Participates in reducing cost of office supply usage resulting in cost effective operations of areas of responsibility., • Participates in the fiscal management initiatives for the facility as directed by leadership in accordance with SP benchmarks., • Ensures effectiveness of internal controls through following all general accountability principles., • Manage work process to maintain high quality standards on increasing case volume., • Utilize all available automation tools. Introduce new or improved tools when applicable., • Provide excellent customer service to all internal and external customers, • Accepts change as an opportunity for growth learning and development. Adapts to changing procedures and goals in a cooperative and positive manner., • Willingness to participate in goal-setting and educational activities for own growth and advancements Qualifications: • Demonstrates eligibility for employment in the U.S., • High School graduate or equivalent, • Minimum of one year of experience in business office activities within a healthcare environment, • Ability to relate and work effectively with others, • Demonstrated verbal and written communications in English for contacting payors patients and co-workers, • Demonstrated computers skills in utilizing work processing integrated database and understanding of mathematical calculations and medical terminology, • Ability to use office machines (copiers faxes and scanners) and telephone systems, • Proficiency using and knowledge of Microsoft Office computers patient accounting systems and Microsoft Excel, • Prior cash handling/collection experience is preferred., • Ability to type 20 WPM OTHER DUTIES Please note this job description is not designed to cover or contain a comprehensive listing of activities duties or responsibilities that are required of the employee for this job. Duties responsibilities and activities may change at any time with or without notice. Patient Population: The patient population served by South Texas Spine & Surgical Hospital is a minimum of 12 years and/or of adult stature to geriatric patients requiring or seeking pain and/or surgical addition our hospital outpatient department patient population served by South Texas Spine & Surgical Hospital is a minimum of 6 months to geriatric patients. Physical Requirements: May be expected to lift to 25 pounds or up to 50 pounds with assistance. Work is of light-demand sitting or walking most of the time while on duty. Visual and auditory acuity and manual dexterity essential to performing designated duties required: optimal auditory acuity required; manual dexterity involving the handling of equipment and computers is essential to performing assigned duties. Physical conditions are clean neat and well-lit. May be subjected to stressful situations. Climate control and ambient temperature variances may be experienced associated with a normal office environment. Hours of duty may be irregular or unexpectedly extended due to the requirements of the Business Office. OSHA Exposure Classification: Job Category III. Tasks/activities do not entail predictable or unpredictable exposure to blood or other body fluids to which universal precautions apply. Required Experience: IC Key Skills Medical Collection,Accounts Receivable,Athenahealth,ICD-10,Medical Coding,10 Key Calculator,Detailing,ICD-9,Medical Billing,Microsoft Excel,CPT Coding,Medicare Employment Type : Full-Time Experience: years Vacancy: 1

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