The Billing Specialist is a key position in the Revenue Cycle, manages the claims process, including accurate and timely claim creation, follow-up and correspondence with providers, insurance inquiries/correspondence. This key person will assist in the clarification and development of process improvements and inquiries, assure payments related to patient services from all sources are recorded and reconciled timely in order to maximize revenues.
Duties:
· Actively participates and coordinates procedures involving billing, coding and accounts receivables resolution
· Ensures proper and complete coding of diagnosis and procedures
· Investigates and resolves claim rejections from clearinghouse, as needed.
· Posts payments and analyzes accuracy of reimbursements
· Prepares and files appeal letters/provider dispute forms on incorrectly paid or denied claims
· Initiates feedback on denial trends and recommendations and action plans to resolve billing and/or coding issues
· Contacts patients as necessary regarding payment on accounts.
· Contacts insurance companies to expedite payment on past due accounts.
· Reviews and requests credit refunds when appropriate.
· Reviews past due accounts and sends to collection agency.
· Speaks with patients or their representatives to identify problems relating to their care/billing.
· Refers patients to appropriate insurance companies or resources with guidance on what action must be taken to resolve their claim denial.
· Supports company's production and collection goals
· Attends staff meetings and in-services
· Follows medical/legal policies such as HIPAA, PHI and ACA related regulations and guidelines.
· Maintains and upgrades standards of performance
Experience:
· Billing and A/R Claims Processing: 3 years (Required)
· Knowledge of the Ophthalmology and Optometry field (Preferred)
· NextGen experience (Preferred)
Job Type: Full-time
Job Type: Full-time
Pay: From $21.00 per hour
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee discount
- Health insurance
Schedule:
- 8 hour shift
- Monday to Friday
Experience:
- Medical Billing: 3 years (Required)
- Ophthalmology: 1 year (Preferred)
Work Location: In person