Business Office Specialist / Medical Billing

Position Summary:

Under the supervision of the Business Office Supervisor and Practice Manager, responsible for handling portions of professional billing, payment posting, research and follow up of unpaid claims including refunds. Promotes a favorable image of the practice to physicians, patients, insurance companies, and the general public.

Teamwork is Priority, you must:

· Work well with others

· Follow the Chain of Command

· Participate in staff meetings and all coding/billing related educational activities

Duties and Responsibilities

· Identifies and reports correct code selection from physician documentation, including, but not be limited to; chart notes, abstracting from medical records documentation and ensures compliant coding.

· Ability to accurately add specific data elements to claims such as modifiers, payer-specific information, including authorization criteria, CPT, and ICD-10 codes.

· Research and verify accuracy of billing data and revise any errors including adjustments and denials.

· Understand and interpret the Correct Coding Initiative (CCI) as it applies to charge entry.

· Reduce denials by the correct use of modifiers and linking diagnosis codes with services.

· Knowledge of in and out of network insurances, insurance verification, patient responsibility, and process for prior authorization.

· Communicates effectively with provider and/or all appropriate parties regarding missing information such as CPT, diagnoses codes, documents, operative reports, etc. to ensure proper coding

· Knowledge of interpreting EOBs, posting payments, and adjusting accounts appropriately.

· Manage the status of accounts and identify reimbursement trends

· Maintain Appeal/denials. Ensure timely completion of appeals.

· Responsible for the processing and discrepancy reconciliation of charge/payment batches

· Ability to successfully track and follow up on information requests.

· Work as part of our team to facilitate information and resolve charge/payment questions.

· Exhibit exceptional customer service skills; answering internal and external calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally.

· Proactive resolution of issues and timely response to questions and concerns.

· Increase revenue by collecting payments on outstanding accounts

· Contact patients regarding outstanding balances

· Establish payment plans to help patients manage payment of bills

· Send delinquent accounts to collections agency

· Create and mail patient collection letters

· Respond to billing questions from patients and staff

· Patient and Insurance Refunds

· Balances and reconciles month end reports

· Cross training in other Business Office areas

· Attends and participates in all coding/billing related educational activities as assigned

· Regular and predictable attendance

· Performs other duties as assigned

Skills needed:

· Problem Solving - Identifies and resolves problems in a timely manner; Gathers and analyzes information skillfully; Develops alternative solutions; Uses reason even when dealing with emotional topics

· Customer Service- Manages difficult or emotional patient situations

· Interpersonal Skills - Focuses on solving conflict, not blame shifting; Listens to others without interrupting; Keeps emotions under control; Remains open to others’ ideas and tries new things

· Oral Communication - Speaks clearly and persuasively in positive or negative situations; Responds well to questions; Participates in meetings

· Written Communication - Writes clearly and informatively; Able to read and interpret written information accurately

· Strong organizational skills

· Proficient in Microsoft Office; emphasis on Excel; 10 Key and strong math skills.

· Ability in work in a high-volume environment

Qualifications:

· High School Diploma or GED

· Minimum two (2) years of experience in a medical billing office

· Gastroenterology experience helpful / not required

· Ability to speak and understand the English language

· Strong ethical and moral character references

· Must pass background check and urine drug screen

· Must be authorized to work in the United States

General Skills:

· Strong experience with 10-key, MS Office (Word, Excel)

· Types a minimum of 40 wpm

· Strong knowledge of Microsoft Excel and Outlook

· Strong organizational skills

Job Type: Full-time

Pay: From $15.50 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• Day shift
• Monday to Friday

Work Location: In person

Salary : $16