Job Description

Medical Billing SpecialistThe Medical Billing Specialist is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts.To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.Extract and verify billing information from medical recordsEnsuring collection of past due balances; follow up as neededEnsure all patient demographic and insurance is accurate prior to submitting claims to insurance companiesAnswer patient account inquiries; assists establish alternative payment plans when necessaryMaintain patient account records; settle third party payer issues as requiredReceive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)Prepare and review patient statements prior to release through PMSEnsure timely filing of all Medicare, Medicaid, and third-party insurance claimsBalance daily charges; reconcile with reports within PMSCollaborate with revenue cycle manager and payers on denials/rejectionsWork closely with practice representatives to ensure proper insurance verifications and authorizations are obtainedOther duties as assignedComply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims ActReport concerns and suspected incidences of non-compliance immediately to the Chief Compliance OfficerCommunicate professionally with patients and guarantors regarding balances or account informationParticipate in required orientation and training programsCooperate with monitoring and audit functions and investigationsParticipate in process improvement responsibilitiesMeet productivity goalsSuccessful completion of required trainingHandle multiple priorities effectivelyProblem solving skills to manage a variety of concrete variablesEffective verbal and written communication skillsAbility to interpret instruction presented in variety of situationsStrong organizational skills; ability to manage multiple projects simultaneouslyProficiency with Microsoft Word, Excel, PowerPoint, and Internet ExplorerTen key speed and accuracyThis Organization is an equal opportunity employer. We do not discriminate based on race, color, religion, sex, handicap, disability, age, marital status, sexual orientation, national origin, veteran status, or any other characteristic(s) protected by federal, state, and local laws. This Organization will make reasonable accommodations for qualified individuals with disabilities should a request for an accommodation be made. A key part of this policy is to provide equal employment opportunity regarding all terms and conditions of employment and in all aspects of a person's relationship with the Organization including recruitment, hiring, promotions, upgrading positions, conditions of employment, compensation, training, benefits, transfers, discipline, and termination of employment.

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