What are the responsibilities and job description for the Billing Specialist- Accounts Receivable position at ENT Associates, Inc.?
This position is hiring for a Billing Specialist- Accounts Receivable. It is a hybrid position after successful completion of training.
Position Summary: Under the direction of the Billing Manager, the employee is responsible for the collection of unpaid claims and appeals. Works with payors to resolve issues and facilitate prompt payment of claims. Follow-up with insurance companies to collect outstanding accounts which payment has not been received in response to the claims submission process, either electronically or by paper.
Reports to: ENTA Billing Manager
Flexibility: While this job description is meant to provide an overview and specific responsibilities of a Billing Accounts Receivable Specialist, ENTA Management reserves the right to make changes, adjustments, and revisions, as needed, to this document and will coordinate such modifications with ENTA’s Practice Administrator and Physicians.
Summary of General Duties:
- Uses A/R follow-up systems and reports to identify unpaid claims for collection/appeal
- Gathers and verifies all information required to produce a clean claim including special billing procedures that may be defined by a payer contract.
- Review and update patient registration information (demographic and insurance) as needed
- Applies appropriate discounts/courtesies based on department policy
- Prepares delinquent accounts for transfer to self-pay collection unit according to the follow-up workflow
- Prints and mails claim forms and statements
- Retrieves supporting documents (medical records, authorizations, etc.) as needed and submits to payers
- Appeals reflected claims and claims with low reimbursement
- Confirm credit balances and gathers necessary documentation for processing refund.
- Identifies insurance issues of primary vs. secondary insurance, coordination of benefits eligibility and any other issues causing non-payment of claims
- Monitor invoice activity until problem is resolved
- Process daily mail, edits reports, file or pull EOB batches
- Identifies and informs Lead and Director of issues or problems associated with non-payment of claims
- Contacts payors or patients as appropriate for corrective action to resolve the issues and receive payment of the claims
- Other assistance to the billing staff as needed which may include posting insurance and patient payments, posting of charges, patient collections, answering patient and insurance calls
- Maintain patient confidentiality
- Knowledge of billing/coding
- Scanning documents into charts
- BayCare interface
- Usage of all online insurance websites including uploading documentation and processing appeals electronically
Working Environment:
- Physical demands:
- Average percent of time during regular shift devote to:
- Walking, Squatting, Sitting, Bending, Reaching:25%
- Standing: 75%
- Average lifting requirements:
- Lifting Requirements: 20-40 lbs.
- Frequency of Lifting: 0-25% of the time
- Average percent of time during regular shift devote to:
- Additional physical demands:
- Ability to grasp with both hands; pinch with thumb or forefinger; turn with hand/arm; reach for (above shoulder height).
- Ability to type 60 wpm.
- Ability to operate multi-line telephone system, computer keyboard and ten-key adding machine.
- Visual, Hearing, and Mental demands: Vision adequate to perform essential functions such as read telephone displays/computer terminals for long periods of time, correctable to 20/20. Hearing adequate to perform essential functions such as answering the telephone. Mental capacity adequate to perform essential functions such as quickly and accurately entering patient demographics and scanning documents while checking in multiple patients. Tact to deal with unfriendly individuals regarding various situations, and adequately handle stress.
- Working Conditions: Normal business office environment. Requires individual to be in uniform daily. Required to exhibit a positive attitude and a professional appearance and show great detail and accuracy. Required to exhibit quality performance of the essential job functions to help the office run effectively and efficiently.
Position Requirements:
- Minimum 2 years of medical billing experience required
- Proficient in Microsoft Outlook, Microsoft Word/Excel, computer knowledge to navigate internet websites such as Availity, Navinet, etc.
- Must be able to communicate verbally and non-verbally in a professional way
- Ability to use time wisely in preparing work area to meet high-paced demand
- Show a genuine desire to work and improve the practice
- Basic coding knowledge
- Strong medical terminology
- Must demonstrate excellent phone etiquette and exceptional customer service skills
