SUMMARY: Performs all billing and collections function of the medical practice to include claim submission, denial appeals, resolving unpaid medical claims, charge entry, fee schedule management, and collections.
ESSENTIAL DUTIES:
- Inputting approved authorizations, appealing denied authorizations, following up on claim status, appealing denied claims, and correcting billing errors.
- Provides administrative support for the billing department by answering incoming calls and text messages, checking and processing incoming mail, checking and answering daily emails.
- Assists patients with billing questions and/or balance inquiries and provides patient estimates for procedures.
- Posts payments and documents payment records and issues in a timely manner.
- Processes all late payments and delinquent accounts by sending past due notices, submitting negotiated reduction letters, setting up payment arrangements, appealing claims denied by carriers, and submitting negligent accounts to attorneys for collection.
- Provides collections recovery support by working closely with the collection attorneys by generating attorney invoices, completing affidavits and notarizing them, processing billing and records requests for attorneys, and calling attorneys for case status.
- Scans and uploads documents and medical records to charts, processes medical records requests, and requests medical records.
- Ability to maintain self-discipline and focus on relevant matters in order to timely complete important tasks.
- Understand opposing points of view on highly complex issues and to negotiate and integrate different viewpoints.Performs other duties as required.
EDUCATION:
Must have a High School Diploma or equivalency.
Associate’s Degree in medical billing and coding preferred.
EXPERIENCE:
Must have at least two (2) years of experience in medical billing and coding.
Pain Management medical office experience preferred.
LICENSES/CERTIFICATIONS:
Medical Billing Certification such as Certified Coding Assistant (CCA), or Certified Coding Specialist (CCS) preferred.
SKILLS:
Must have the following skills and/or abilities:
- Strong knowledge of medical classification systems such as ICD-9, ICD-10, CPT, DSM-IV, and HCPCS.
- Working knowledge of third-party payers such as HMOs, PPOs, Medicare, Medicaid, and Worker’s Compensation.
- Working knowledge of ERAs and EOBs.
- Working knowledge of payer specific/LCD guidelines.
- Understanding of health plan benefits (deductibles, copays, coinsurance) and eligibility verification.
- Understanding of CMS billing rules/NCCI, HIPAA and RMH policies and procedures, billing edits and payer requirements for Professional Billing.
- Working knowledge of EMR systems such as eClinicalWorks, Allscripts, Practice Fusion, Epic, Cerner, etc.
- Strong computer and keyboard skills which includes MS Word and Excel, ten-key number pad or calculator by touch.
- Excellent interpersonal and communication skills (both written and oral) when working with patients or co-workers.
- Excellent customer services skills to interact with patients in a positive, cooperative, and courteous manner.
PHYSICAL ACTIVITIES:
- Constantly sits or stands within a given day while conducting work functions such as inputting data, talking on the phone with patients/insurance representatives, responding to billing inquiries, operating keyboard, and interacting with patients and coworkers.
- Constantly using fingers and hands when typing, using a 10-key number pad, handling pens/pencils, forms/paper, telephone, tools, or other computer or office equipment.
- Frequently lifts, transfers, pushes, or pulls up to 15 lbs. of files, supply boxes, or other small office equipment.
- Hears average or normal conversations and receives ordinary information through verbal communications.
- Average, ordinary visual acuity necessary to utilize the computer or other office machinery, and to read or write instruction manuals or other documents.
- Frequently move about the office which may include climbing stairs, stopping, kneeling, and/or bending.
WORKING CONDITIONS:
Medical office atmosphere located inside a building with some hazardous or significantly unpleasant conditions. Minimal exposure to medical equipment such as autoclaves, stethoscopes, sphygmomanometers, EKG electrodes, AEG machines, scales, and hemoglobin testing machines.
CONCEPTUAL/INTELLECTUAL ACTIVITIES AND OTHER REQUIREMENTS
- Frequently convey detailed or important instructions or ideas accurately, clearly, and/or quickly.
- Understand, remember, follow, and exchange basic instructions, information, and guidelines.
- Technology savvy with the ability to learn new software quickly.
- Project a courteous, professional and positive demeanor with co-workers and patients while performing essential duties.
- Organize thoughts and ideas into understandable terminology.
- Dependable attendance and punctuality are necessary to perform the essential job duties.
- Ability to apply common sense reasoning and decision-making to carry out detailed, involved billing transactions and to resolve problems involving several concrete variables.
- Listen to others and objectively considers others’ ideas and opinions, even if they conflict with one’s own.
Job Type: Full-time
Pay: $19.00 - $23.00 per hour
Ability to Relocate:
- Boerne, TX 78006: Relocate before starting work (Required)
Work Location: In person