Under the direct supervision of the Billing Operations management is responsible for collecting, posting and maintaining accounts payments.
Submits claims and follows up with patients and insurance companies. Provides excellent customer service and support to patients, business partners and/or public in general.
Tasks and Responsibilities
A. Essential Duties
• Treats patients in a polite, friendly, prompt and helpful manner.
• Reviews encounters received for all pertinent information: patient information, insurance information, service descriptors, diagnosis codes and managed care authorization requirements.
• Prepares and submits electronic/paper claims to insurance companies or invoices to corporate accounts.
• Prepares, reviews and sends patient statements.
• Analyzes and ensure the accuracy of in information in the billing system.
• Enters, reviews and retrieving patient account information from E-Clinical.
Ensures accuracy of information.
Reconciles information on encounter form with information in E-Clinical. Investigates reject claims.
• Promptly identifies and resolves patients, insurance companies, laboratories, and related offices billing complaints
• Serves as a liaison for all correspondence and queries pertaining to billing issues.
• Signs all outgoing faxes and company correspondence with name and job title.
• Prints and submits claims forms to all carriers and patients.
• Continues routine follow-up of claims submitted to monitor payment status.
• Performs collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Follows and reports status on delinquent accounts.
• Process payments from insurance companies and patients and prepares a daily deposit.
• Submit completed batches, including vouchers, transmittals, bank deposit slips, copies of checks, and credit card receipts.
• Reviews and processes medical record requests from all entities in keeping with our Client’s Policy and to the letter of the law.
• Assists in credentialing for the providers with the insurance companies.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations. Assures patients confidentiality at all times.
• Participates in educational trainings and orientations to maintain and advance competency.
• Requires working on evenings, weekends and Holidays; based on rotation schedule.
• Answers phone by the third ring and returns all phone messages promptly and by the end of the business day.
• Is responsible for the cleanliness, neatness, proper organization and upkeep of their cubicle or office space.
• Maintains facility compliance with HIPAA laws. Ensures all paperwork and computer data files containing sensitive information such as patient demographic data, social security numbers, credit card numbers, insurance policy information, financial information and other highly sensitive information are locked down or disposed of in the shredding bins expressly provided for that purpose.
• Every voice mail will be returned by the end of the morning or by the end of the business day, depending on when it was received. Percent of incoming calls to voice mail - 10% or less.
• Remains current with company emails.
B. Incidental Duties
• Performs other job-related activities as they are needed to achieve the purpose of the job.
• Provide assistance to other departments on incidental duties.
• Trains and assists and covers when necessary to maintain high productivity and efficiency in the department.
C. Interpersonal Relations
• Oral and written communication with employees at all levels of the business for support, and share information.
• Seeks to maintain a constructive work environment.
Performance Standards and Measurement
Super nice and more importantly SAFE work environment. Rapidly growing company with great benefits!
The Billing Associate job will be measured in the following ways:
• Compliance with essential and incidental duties.
• Compliance with company policies and procedures
. • Adherence to and application of our Client’s Core Values
• Compliance with state and federal laws and regulations applicable to their role.
Requirements• Talk and hear both by person and by telephone; ability to speak clearly and effectively using proper grammar before patients and business partners, among others.
• Use hands to finger, handle, feel or operate standard office equipment. Reach with hands and arms. Visual sharpness is required.
• Ability to work under pressure.
Able to handle multiple tasks and interruptions and manage conflicting priorities.
• Excellent interpersonal and communications skills.
• Detail oriented and excellent organizational skills.
• Demonstrates ability to function effectively as a part of a team.
• Ability to express ideas concisely and clearly, orally and in writing.
• Ability to function independently and with flexibility.
• Basic math skills.
• Demonstrates sound judgment, common sense and professionalism in all areas.
• A well-groomed, business-like appearance.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of the job.
HIPAA Regulatory Information- Level of Access to Protected Health Information:
Level 3- Full access to the Medical Record Subset of the Designated Record Set
• High School graduated.
• Two (2) years of college and/or an Associate Degree (AA) is helpful. Must provide proof of graduation.
? One (1) year of experience working in a customer service environment and/or medical office setting is highly desirable.
? Knowledge of medical coding and third-party operating procedures and practices is highly desirable.
• Knowledge of government regulatory requirements applicable to their role.
• Computer Literate: Excel, Word and PowerPoint are desirable. E-Clinicals knowledge is helpful.
License and/or Certifications: Certification in Medical Billing is helpful. Proof of Certification required.