Responsible for overseeing the entire claims management process from claims generation to the posting of the receipt of payment.
Duties and Responsibilities:
Maintains procedures for efficient and accurate processing of encounters in the billing department. Works independently to review Progress Notes and code as appropriate.
Responsible for the timely submission of insurance claims. Oversees the processing of all encounters and pertinent information to be sent to the insurance companies on a daily/weekly basis. Ensures accuracy of claims submitted. Follows up (denials/underpayments) as necessary.
Under the direction of the Director of Billing, coordinates the paper/document flow related to billing and patient accounts, including but not limited to:
Assists the Director of Billing in the identification and establishment of relationships with third party insurers to improve patient revenue.
Supervises the monitoring and reconciliation for all third party insurance remittances and cash collections.
Prepares other written documentation as required by the profession and the department; maintains, distributes, analyzes and projects information for required records, reports and statistics as directed.
Counsels patients regarding available Insurance options.
May negotiate payment terms on outstanding patient balances owed.
Performs other functions relative to Accounts Receivable and Credit and Collections,
Attends meetings as required.
Performs other relevant duties as assigned.
Physical Demands: Requires periods of sitting, standing, walking, bending and stooping. Significant job stress may be associated with the position. Evening work may be required.
Minimum Qualifications: Associate’s degree in Business Administration, Accounting, Medical Assisting or other related field. Comprehensive knowledge of medical terminology. Three (3) years of Medical Billing Experience. Two (2) years of experience electronic billing using EMR/EHR. Proficiency with ICD9 and CPT coding. Demonstrated critical thinking, creativity, problem solving and decision-making skills. Exceptional organizational, communication (verbal and written), and facilitation skills. Computer literacy a must. Proficiency in MS Office.
Preferred Qualifications: Bachelor’s degree in Business Administration, Accounting, or other related field. Five (5) years of Medical Billing Experience. Experience with eClinical Works.