Job Summary
Follows patient accounts through the entire billing process from eligibility to completion of payment process. Provides medical billing and collection processes by verifying eligibility and benefits obtaining preauthorizations entering medical codes requesting payments and resolving account issues. This position is onsite during training. After training is complete employees in this position are eligible to work from home/remotely.
Responsibilities
1. Contacts patients and insurance companies for payments requests overdue payments denied claims and arranges payment plans. 2. Enters medical codes from patient charts for visits or procedures and ensures compliance and correct coding practices. 3. Contacts insurance companies for explanation of benefits preauthorizations and to resolve claim issues. 4. Produces reports to reduce age trial balances by contacting patient for collection or sending secondary claims. 5. Provides customer service to patients by educating them on insurance policies billing procedures and coding issues. 6. Calls patients and insurance companies to followup with account information. 7. May provide training to others on billing procedures and practices. Problem Solving The Billing Specialist directly affects the unit or clinic profitability by following up for payment and accurately coding visits and procedures. This position has the authority to negotiate payment settlements for patients or with insurance companies and authorize patient discounts within the policy and procedure guidelines. The incumbent resolves issues with insurance companies regarding incorrect registration information claims processing contract reimbursement amounts and coding issues. Work Environment and Level of Frequency typically required Nearly Continuously: Office environment. Physical Requirements and Level of Frequency that may be required Nearly Continuously: Sitting hearing listening talking. Often: Repetitive hand motion (such as typing) walking. Seldom: Bending reaching overhead.
Minimum Qualifications
Three years medical billing experience and one year of coding experience using ICD 10CM or equivalency (one year of education can be substituted for two years of related work experience) required. Thorough knowledge of entire billing process demonstrated computer skills human relations and effective communication skills are also required. Applicants must demonstrate the potential ability to perform the essential functions of the job as outlined in the position description.
Required Experience:
Unclear Seniority