Billing & Collection Specialist

The Department of Psychiatry Production Unit is seeking a Billing & Collection Specialist to be responsible for the collection of unpaid third-party claims and resolution of non-standard appeals, using various JHM applications and JHU/ PBS billing applications.

Specific Duties & Responsibilities

• Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal.

• Conduct on-line research to locate information to resolve issues across different sub-specialties and/or relating to high-cost procedures.

• Communicates 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 claim's submission process, either electronically or by paper.

• Use a comprehensive knowledge of claims submission requirements for all payors in order to expedite payments.

• Research and interpret medical policies regarding denials based on medical necessity. Will use a working knowledge of local coverage determinations (LCD's) to research and apply appropriately.

• Mentor and advise junior specialists as appropriate.

Professional & Personal Development

• Participate in on-going educational activities.

• Complete three days of training annually.

Must adhere to Service Excellence Standards

• Customer Relations

• Self-Management

• Teamwork

• Communications

• Ownership/Accountability

• Continuous Performance Improvement

Knowledge, Skills & Abilities

• Ability to use various billing and patient information computer systems.

• Knowledge of various payer processing and submission guidelines.

• Able to maintain consistent above average productivity due to comprehensive knowledge, and ability to make data based and timely decisions.

• Comprehensive knowledge of and compliance to HIPAA rules and regulations in the dissemination of patient Protected Health Information (PHI).

• Comprehensive knowledge of medical billing applications.

• Utilize online resources to research policy and regulations to facilitate efficient claims processing.

• Ability to resolve issues across different sub-specialties, and/or specialized/complex high value procedures.

• Excellent interpersonal, communication and customer service skills required.

• Knowledge of medical terminology, CPT codes and diagnosis coding.

• Demonstrated experience resolving third-party payor insurance processing issues, including appeals and denials.

• Ability to perform on-line research and analyze data for conclusive thought.

Physical Requirements

• Able to sit in a seated position for extended periods of time.

• Able to reach by extending hand(s) or arm(s) in any direction.

• Finger dexterity required, able to manipulate objects with fingers rather than entire hand(s) or arm(s), e.g., use of computer keyboard.

Minimum Qualifications

• High School Diploma or graduation equivalent.

• Two year's experience in a medical billing, insurance follow-up processing, or similar medical specialty environment.

Classified Title: AR Revenue Cycle Specialist II

Job Posting Title (Working Title): Billing & Collection Specialist

Role/Level/Range: ATO 40/E/02/OD

Starting Salary Range: $16.00 - $28.50 HRLY ($40,560 targeted; Commensurate with experience)

Employee group: Full Time

Schedule: M - F/ 40 hours a week

Exempt Status: Non-Exempt

Location: Hybrid/School of Medicine Campus

Department name: ???????SOM Psy Production Unit

Personnel area: School of Medicine

Equal Opportunity Employer

Johns Hopkins University is an equal opportunity employer and does not discriminate on the basis of race, color, gender, religion, age, sexual orientation, national or ethnic origin, disability, marital status, veteran status, or any other occupationally irrelevant criteria. The university promotes affirmative action for minorities, women, disabled persons, and veterans.