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The role includes processing credits, resolving denials and billing errors, prior authorization for surgical procedures, posting payments and remittance advice, and maintaining Medicare/Medicaid logs and credit-report accuracy. It also covers patient-facing support in the business office, registration assistance, documentation scanning, deposit/co-pay collection, payment arrangements, and confidentiality, professionalism, and ongoing education requirements.",{"@graph":63,"@context":118},[64,80,101],{"@type":65,"itemListElement":66},"BreadcrumbList",[67,71,74,77],{"item":68,"name":69,"@type":70,"position":9},"https://docshare.wps.com","Home","ListItem",{"item":72,"name":10,"@type":70,"position":73},"https://docshare.wps.com/template/",2,{"item":75,"name":21,"@type":70,"position":76},"https://docshare.wps.com/template/invoices/",3,{"item":78,"name":59,"@type":70,"position":79},"https://docshare.wps.com/template/billing-specialist-job-description-billing-specialist-duties-requirements/258753/",4,{"url":78,"name":59,"@type":81,"image":82,"author":87,"headline":59,"publisher":90,"fileFormat":93,"inLanguage":57,"description":61,"dateModified":94,"datePublished":95,"encodingFormat":93,"isAccessibleForFree":96,"interactionStatistic":97},"DigitalDocument",{"url":83,"@type":84,"width":85,"height":86},"https://docshare.wps.com/thumbnails/billing-specialist-job-description-billing-specialist-duties-requirements/258753.png","ImageObject",442,249,{"name":88,"@type":89},"Quinn","Person",{"url":68,"name":91,"@type":92},"DocShare","Organization","application/pdf","2026-10-17","2026-09-13",true,{"@type":98,"interactionType":99,"userInteractionCount":76},"InteractionCounter",{"@type":100},"ViewAction",{"@type":102,"mainEntity":103},"FAQPage",[104,110,114],{"name":105,"@type":106,"acceptedAnswer":107},"What core responsibilities does the Billing Specialist perform?","Question",{"text":108,"@type":109},"The role files insurance claims using UB and HCFA forms, imports charges for timely transmission, follows up with payers, processes denials, and maintains accurate billing documentation and logs.","Answer",{"name":111,"@type":106,"acceptedAnswer":112},"What Medicare and Medicaid-specific tasks are included?",{"text":113,"@type":109},"The Billing Specialist maintains Medicare/Medicaid IP account responsibility logs, keeps Medicare bad debt logs for year-end submission, reviews accounts with credit balances, and posts electronic remittance advice.",{"name":115,"@type":106,"acceptedAnswer":116},"What patient-facing and administrative duties are required?",{"text":117,"@type":109},"The position greets patients and families, assists with billing questions and insurance coverage concerns, supports efficient registration, ensures required documents are scanned into One Content, and sets up payment arrangements for self-pay patients.","https://schema.org",{"og:url":78,"og:type":120,"og:title":59,"og:site_name":91,"og:description":61},"article",{"robots":122,"canonical":78},"index,follow",{"doc_id":124,"site_id":56},258753,1790625224,{"code":4,"msg":5,"data":127},{"doc_id":124,"user_id":128,"nickname":88,"user_avatar":129,"doc_module":9,"category_id":20,"category_name":21,"doc_title":59,"doc_description":61,"doc_content":130,"file_id":131,"file_url":132,"file_type":133,"file_size":134,"view_count":76,"is_deleted":4,"is_public":9,"is_downloadable":9,"audit_status":9,"page_count":76,"language":135,"language_code":57,"site_id":56,"html_lang":57,"table_of_contents":136,"faqs":137,"seo_title":138,"seo_description":61,"update_tm":139,"read_time":9},962075114765,"https://ap-avatar.wpscdn.com/davatar_a8503ba1806abce46bf441b54a3ca4cd","Billing Specialist JOB DESCRIPTION  \n\n| Position Title:\u003Cbr>Job Classification:\u003Cbr>Department:\u003Cbr>Reports to:\u003Cbr>Last Update: | Billing Specialist\u003Cbr>\u003Cbr>Business Office | Exemption Status: Non-Exempt |  |\n| --- | --- | --- | --- |\n|  |  | Job Code: GS 14 |  |\n|  |  |  |  |\n|  | Assistant Director of Business Office December 14, 2018 |  |  |\n\nJob Summary  \nUnder general supervision, is responsible for representing Roosevelt General Hospital and RGH Clinic as an exemplary hospital in the region. The Billing Specialist position requires fundamental knowledge of filing insurance claims on UB and HCFA claim form, how insurance companies pay accordingly to contracts established with the hospital, how to read and interrupt an insurance explanation of benefits (EOB), process denials, import charges and do precise follow-up with the insurance company via, phone, email, insurance websites, etc. at an acceptable volume per day. RGH Insurance specialist will be the embodiment of the hospital’s mission, vision and values. The Billing specialist will greet patients or family members upon arrival within the business office and assist them in answering any questions or concerns they may have regarding billing issues. The insurance specialist will have knowledge of all aspects of the department process from the registration process thru the billing.  \nEssential Functions:  \nBusiness Office (will report to Business Office Director for these functions)  \n• Promote the mission, vision, and values of the organization  \n• Import charges from queues in a timely manner and append modifiers or any required information for claim transmission  \n• Prepare statements for patients on a daily/weekly basis  \n• Process patient and insurance credits  \n• Obtains prior authorization from insurance companies for surgical procedures  \n• Review daily accounts that are ready to be billed in Relay Health/Payer Path  \n• Initiate correction on all claims with errors by the designated time  \n• Follow up on any correspondence that may have been received on that day or the previous day  \n• Cross train on billing all lines of business to the different payers  \n• Pull listing of all accounts assigned to be follow up by specific payer  \n• Diagnostic and procedural coding  \n• Medicare specialist will maintain log ofall Medicare / Medicaid IP accounts that Medicaid pays only a portion of the patient’s responsibility.  \n• Medicare specialist will maintain all Medicare bad debt log listing to be turned in at the end of the year  \n• Medicare specialist will complete and review all Medicare accounts that may have a credit balance and resolve the account balance before the quarterly Medicare credit report is due  \n• Work all accounts that have a credit balance  \n• Post payments from the different payers to patients accounts  \n• Medicare specialist will post all Medicare and Medicaid electronic remittance advice  \n• Insurance specialist will assist in registering patients efficiently and accurately, obtaining appropriate signatures, completing all required forms and providing patient information as required by state and federal regulations and departmental guidelines  \n• Assure that all required documentation is scanned in appropriately into One Content for each registration; to include the following:  \n􀂃 Driver’s License  \n􀂃 Insurance Cards  \n􀂃 Conditions of Admission, COA  \n􀂃 Orders  \n􀂃 SS Card (When Available)  \n• Be able to visit patients in their room to complete or validate information, as necessary  \n• Assure that the collection of deposits and co-pays when applicable  \n• Enters relevant information into computer system  \n• Sets up payment arrangements with self-pay patients  \n• Assists patients with questions concerning their insurance coverage  \n• Advises self-pay patients of their medical and dental care options available in the community for future follow-up care  \n• Explains hospital regulations, such as visiting hours, payment of accounts, charges, etc.  \n• Participates","cbCaitz5seslkQoe","https://ap.wps.com/l/cbCaitz5seslkQoe","pdf",49980,"English","# Job Summary\n## Essential Functions\n## Non-Essential Functions\n## Professional Requirements\n## Qualifications\n## Knowledge, Skills, and Abilities","[{\"question\":\"What core responsibilities does the Billing Specialist perform?\",\"answer\":\"The role files insurance claims using UB and HCFA forms, imports charges for timely transmission, follows up with payers, processes denials, and maintains accurate billing documentation and logs.\"},{\"question\":\"What Medicare and Medicaid-specific tasks are included?\",\"answer\":\"The Billing Specialist maintains Medicare/Medicaid IP account responsibility logs, keeps Medicare bad debt logs for year-end submission, reviews accounts with credit balances, and posts electronic remittance advice.\"},{\"question\":\"What patient-facing and administrative duties are required?\",\"answer\":\"The position greets patients and families, assists with billing questions and insurance coverage concerns, supports efficient registration, ensures required documents are scanned into One Content, and sets up payment arrangements for self-pay patients.\"}]","Billing Specialist Job Description - Billing Specialist Duties & Requirements | PDF",1789325720]