What are the responsibilities and job description for the Medical Billing A/R Specialist position at Eye Medical Center of Fresno, Inc.?
Position: Medical Billing Specialist
Primary Duties:
With precision and accuracy, prepare and submit each claim. Ensuring each goes out clean, with up-to-date medical information and billing codes, to guarantee accurate payment at first submission. As necessary, perform any follow up tasks required in pursuit of proper payment.
- Meet daily, monthly and quarterly collection goals set by billing supervisor.
- Process number of accounts per day as assigned.
- Analyze EOBs and construct response to insurance carriers based on claim adjudication.
- Manage AR of assigned accounts including processing insurance denials and or appeals, which may include phone contact with insurance companies.
- Follow up with payers and other appropriate parties to collect open balances in a timely manner, ensuring compliance with payer guidelines.
- Initiate refund requests for supervisor’s approval.
- Identify and report payer issues with regard to rejection trends, denial trends, or change in payments. Communicate specific payer information to appropriate parties and or departments.
- Identify and address denial and or zero payments and correct billing submissions.
- Follow up and complete tasks on pending accounts in a timely manner and until account is settled.
- Other job duties as assigned.
Other Job Criteria:
- Exhibit high levels of customer service and communication skill, verbal and writing, in all interactions both internally and with outside companies.
- Ability to proficiently utilize all company technology to perform job duties (e.g., answer phones, send emails, and updating patient accounts as needed).
- Blend education, skills and experience on an ongoing basis.
- Ability to work in a team setting and independently with minimal supervision, alternating between each as circumstances require.
- Advanced time management skills, efficiently complete job duties with extreme accuracy.
- Advanced organization skills, using professional judgment to prioritize high volume workload.
- Maintain patient and job confidentiality, ensuring compliance with HIPAA standards.
- Appearance and habits do come to work with presentable personal hygiene and attire.
- Reliable, dependable, and able to maintain job attendance with minimal absence.
- Perform job duties in spite of unforeseen obstacles, with versatility and positive personal temperament under stress and or pressure.
- Sitting and for long periods of time.
Education/Experience:
- High School Diploma or GED
- Two or more years of experience in medical accounts receivable (AR), claims billing, appeals, processing denials, and submitting electronic data interchange (EDI) claims.
- Extensive experience and proficiency in date entry.
- Proficiency in explanation of benefits (EOB) analysis, payment adjustments, and medical terminology.
- Proficiency in understanding of CPT and HCPCS codes, AR follow-up, and payment reconciliation, and all revenue cycle functions and interrelationships.
- Medi-Cal billing experience required.
Job Type: Full-time
Pay: $39,520.00 - $52,000.00 per year
Benefits:
- 401(k)
- 401(k) matching
- Dental insurance
- Employee assistance program
- Employee discount
- Flexible spending account
- Health insurance
- Life insurance
- Paid time off
Schedule:
- Monday to Friday
Work Location: In person
Salary : $39,520 - $52,000