906 H St. NE
Under the general supervision of HIPS’ Director of Programs, the Data and Medical Billing Specialist (DMBS) will perform basic data management and be responsible for secondary data collection as required by the program. The DMBS will also produce standard data analyses of information collected and be responsible for producing all standard reports required by different program. Additionally the DMBS will work alongside HIPS data team to create a new database and assist in the training of HIPS staff in making the switchover from paper forms and files to a comprehensive electronic database. This position will provide training and technical assistance to project partners. The ideal candidate will have an innovative approach to data management and analysis as well as experience in creating data systems. Furthermore, the ideal candidate will have experience with medical billing and will be responsible for the timely submission of technical and professional medical claims to insurance companies.
Data and Quality Assurance
● Conduct data mining in a timely and accurate manner as required by the program.
● Produce standard analyses and standard reports using a variety of data which support the development, implementation, and monitoring of programs.
● Perform basic data manipulations using software packages such as Microsoft Excel or Google Sheets.
● Assist in the preparation of oral and written reports/presentations of project work and ongoing project evaluations as requested by the Director of Programs to better inform decision making.
● Conduct quality control check on data, reports, and other deliverables and resolve discrepancies internally.
● Test, track and monitor data for quality, integrity and trend analysis.
● Merge multiple databases and data sources using Microsoft Excel, Google Sheets, Eval Web and REDCap, ECW.
● Participate in the development of project objectives, data collection, and analysis and work plans in collaboration with project team members including participating in all project status meetings.
● Schedule and coordinate activities related to data collection and analysis in order to meet deadlines.
● Translate hard copy paper data collection forms into database queries.
● Develop additional queries and reports to support analysis. These include running pre-defined queries and reports and ad hoc queries and reports as requested.
● Work with software developers to troubleshoot and improve database related tools/applications
● Train users in database concepts and usage of database related tool/applications
● Develop documentation and configuration control procedures for queries and reports
● Process raw data to populate database tables using existing tools Medical Billing
● Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
● Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
● Following up on unpaid claims within standard billing cycle time frame.
● Checking each insurance payment for accuracy and compliance with contract discount.
● Calling insurance companies regarding any discrepancy in payments if necessary.
● Identifying and billing secondary or tertiary insurances.
● Researching and appealing denied claims.
● Updating billing software with rate changes.
● Updating spreadsheets and running collection reports.
● Knowledge of business and accounting processes usually obtained from an associate's degree, with a degree in Business Administration, Accounting, or Health Care Administration preferred.
● Knowledge of insurance guidelines including HMO/PPO, Medicare , Medicaid , and other payer requirements and systems.
● Competent use of computer systems, software, and 10 key calculators.
● Familiarity with CPT and ICD-10 Coding.
● Knowledge of accounting and bookkeeping procedures.
● Knowledge of medical terminology likely to be encountered in medical claims.
● Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
● Minimum of 2 years of experience in a medical billing.
● Prior experience/skills in appropriate computer, statistical and/or database applications.
● Demonstrated analytical and problem-solving skills
● Strong communication skills, both oral and written.
WORKING CONDITIONS: This is a full time position with benefits (40 hours/week). HIPS employees are eligible for health, dental, vision, life, short and long term disability insurance benefits as well as access to health flexible spending account. This position will be eligible to participate in HIPS 401K retirement plan after one year of service. This position will work both on-site and remotely. Some travel may be required to attending meetings or training pertinent to the role. This position requires lifting 15-25 pounds; regular physical activity; regularly walking up and down stairs; and regularly sitting for long periods of time.
HIPS comprehensive benefits package includes: 100% employer sponsored medical, dental, vision, and life plans as well as a general accrued paid time off that starts accruing on your first day at HIPS. As an employee, you have access to a health flexible spending account. After one year of service, employees can enroll in HIPS 401k retirement plan.
Minimum Education Required