Medical Billing/Collecting Specialist

POSITION SUMMARY

Responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid. Gather charge information, codes, enter/verify data in the Practice Management System, complete billing process and distribute billing information. Responsible for collection of delinquent patient accounts.

ESSENTIAL FUNCTIONS

BILLING

• Researches all information needed to complete billing process including getting charge information from physicians.
• Codes information about procedures performed and diagnosis on charge.
• Keys charge information into on-line entry program and produces billing.
• Works with other staff to follow-up on accounts until zero balance or turned over for collection.
• Assists with coding and error resolution.
• Assists with answering the telephone and provides information as requested.
• Maintains required billing records, reports, files.
• Participates in educational activities.
• Maintains strictest confidentiality.

COLLECTION

• Identifies delinquent accounts, aging period and payment sources. Processes delinquent unpaid accounts by contacting patients and third party responsible for reimbursement.
• Performs various collection actions including contacting patients by phone and resubmitting claims to third party responsible for reimbursement.
• Evaluates patient financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
• Reviews accounts for possible assignment makes recommendation to Billing Supervisor and prepares information for collection agency.
• Assigns uncollectible accounts to collection agency or attorney via clinic Credit and Collection policy. Contacts lawyers involved in third-party litigation.
• Answers inquiries and correspondence from patients and insurance companies. Using Clinic approved correspondence letters.
• Identifies and resolves patient billing complaints. Researches credit balances.
• Participates in educational activities.
• Maintains strictest confidentiality.

OTHER

• Other duties as assigned.

KNOWLEDGE, SKILLS AND EXPERIENCE

Minimum Education (or substitute experience) required:

• High School graduation or GED.

Minimum Experience required:

• Minimum of three years billing experience in a health care organization. Knowledge of medical terminology desirable. Word processing and computer experience.

Skills required:

• Able to think and act independently on assigned tasks.
• Demonstrates increasingly more ability to troubleshoot and solve overall issues.
• Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
• Use of computer systems, software, 10 key calculator
• Effective communication abilities for phone contacts with insurance payers to resolve issues
• Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
• Able to work in a team environment
• Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
• Knowledge of accounting and bookkeeping procedures
• Knowledge of medical terminology likely to be encountered in medical claims

Current Openings for Medical Billing/Collecting Specialist Jobs at Sacramento Ear, Nose & Throat