Denali OB-GYN Clinic Job Description
JOB TITLE: Medical Billing Specialist/Accounts Receivable
STATUS: Non-exempt
REPORTS TO: Director of Patient Business Services, Executive Director
RESPONSIBILITIES:
Work directly with insurance companies and other staff members to optimize claim processing and payment. Maintain the viability of the company by accurately preparing and submitting paper or electronic claims to the appropriate payer, analyzing, and resolving claim rejections and denials. Monitor claim utilization and payment and communicate necessary information to Director of Patient Business Services.
JOB DUTIES:
1. Post insurance and patient payments.
2. Monitors and verifies correct payment of claims.
3. Work denied claims by submitting additional documentation as needed or working with coding team to ensure accuracy of billed charges and submitting corrected claims.
4. Analyze and resolve claim rejections and denials using Claims Tracking and Claims Control in Practice management system.
5. Appeal claims in a timely manner.
6. File secondary and tertiary claims electronically or by paper.
7. Identify refunds due for patient accounts and forward to Director.
8. Identify and audit insurance overpayments and initiate overpayment recoveries.
9. Work Insurance A/R by following up with insurance companies to check claim status.
10. Work patient A/R by calling patients regarding past due balances and setting up payment plans.
11. Answers patient questions, identify and resolves patient billing complaints.
12. Ensure authorizations are entered into the patients account and tied to the appropriate service.
13. Adheres to all Denali OB-GYN Clinic policies and procedures.
14. Other duties as requested by Director of Patient Business Services.
JOB REQUIREMENTS:
· Education: High school diploma or GED
· In-depth knowledge of third-party payer reimbursement policies and procedures
· Use of computer and other office equipment
· Ability to operate coding and billing programs, Practice Management and EHR systems.
EXPERIENCE:
· Two years insurance billing experience in a physician office preferred.
· Credentials: Certified Professional Biller (CPB) or Certified Professional Coder (CPC), preferred
JOB RELATIONSHIPS:
· Does not supervise any other employee.
· Reports to Director of Patient Business Services and/or Executive Director in all matters.
SUCCESS FACTORS
· Must be thorough and dependable
· Must be detail oriented
· Must possess good oral and written communication skills
· Must maintain credentials
· Must keep current with third-party payer reimbursement policies through continuing education
· Must possess good customer services skills
· Must maintain confidentiality of patient health records and patient account data
WORKING CONDITIONS
Reasonable accommodations may be made to enable individuals with disabilities to perform the job duties.
· Work is performed primarily inside and office setting with heated, ventilated, and well-lighted environment.
· Job is considered low risk for hazard exposure.
· Denali OB-GYN is a non-smoking facility
· Requires speaking, sitting, standing, bending, reaching, lifting under 50 lbs, and may involve driving personal vehicle on company business.
· Requires manual dexterity sufficient to operate standard office and other equipment or appliances.
· Requires normal range of hearing and vision acuity.
Note: This job description is not intended to be all-inclusive. The employee may perform other related duties as negotiated to meet the ongoing needs of the organization.
Job Type: Full-time
Pay: $23.00 - $26.00 per hour
Expected hours: 40 per week
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Health insurance
- Paid time off
Schedule:
- 8 hour shift
- Monday to Friday
Work setting:
Experience:
- Medical billing: 2 years (Preferred)
License/Certification:
- Certification in Medical Coding and Billing (Preferred)
Work Location: In person