This position is responsible for implementing and enforcing policies and procedures, as well as
streamlining effective billing processes and assisting in the entire billing department at the company.
Duties and responsibilities
Sends insurance claims no later than five days post printing date and posts batches Verifies and compares procedure codes (CPT codes), diagnosis, and insurance card information to the patient’s exam Utilizes problem-solving skills to research and resolve discrepancies, denials, appeals, and insurance mail-backs Verify and confirm proper coverage through eligibility and benefit verification Implements and enforces all company rules, procedures and policies Utilize monthly aging accounts receivable reports to follow up on unpaid claims aged over 30 days Daily review of suspended/RTP claims through DDE access Document communications on collection activity, with insurance companies and patients in the EHR Make corrections as necessary to ensure timely payment and completeness of all claims with a goal of zero errors Review daily remittance advice for denials Notify billing manager of any HMO or eligibility issues Regularly meets with billing manager on all issues and billing obstacles Ensure RAPs are reprocessed within 24 hours of cancellation Research and analyze patient account activity to maintain accuracy of patient account balances Resolve credit balance accounts on a monthly basis and recommend account adjustments as appropriate Responds to all inquiries from insurance companies, patients and providers Regularly attend monthly staff meetings and continuing educational sessions as requested Assures the accuracy of accounts being transferred to bad debt and/or collections Receives and logs all incoming batches Monitors staff for compliance with HIPAA regulations and maintaining strictest confidentiality Demonstrate excellent customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members Attend to issues relating to patient complaints and takes measure to correct situation and ensures appropriate personnel are involved Confers and cooperates with other department managers to ensure coordination client activities Other duties as assigned
Qualifications
Ability to effectively interact with doctors, patients, attorneys and other staff members.
Minimum 2 years’ experience with Medicare insurance billing and AR related duties preferred Ophthalmology and ASC – Accounts Receivable experience preferred EHR experience preferred Medicare DDE computer billing system experience needed Strong customer relations skills Strong verbal and written communication skills Strong computer/ internet knowledge/ 10-key Demonstrate knowledge of proper, safe, efficient usage of current office equipment Superior command of English language in writing and communication Professional in appearance, organized, and prompt Must be punctual, efficient, and detail oriented Some level of practice management software experience Respectful of all privacy requirements for HIPAA and also all personnel information Types 35-45 WPM
Working conditions
Frequently exposed to noise and a regular flow of people around the office Frequently assigned to changing priorities May be required to work overtime and/or Saturdays
Physical requirements
Ability to stand, walk, sit, use hands, reach with hands and arms, speak and hear; may occasionally be asked to lift up to 15 pounds.
Normal physical mobility that includes movement from place to place.
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