What are the responsibilities and job description for the Patient Billing Specialist position at Maine Optometry?
The Patient Billing Specialist at our Optometry Office plays a crucial role in managing and optimizing the revenue cycle by ensuring timely and accurate collection of outstanding patient balances and insurance claims. This position requires constant patient interaction, strong customer service, communication and problem-solving skills to maintain positive patient relationships while maximizing collections and comfortability being on the phone for extended periods.
Key Responsibilities:
Customer Service:
- Answer and return patient phone calls in a timely manner in accordance to Company policy.
- Provide excellent customer service to patients regarding billing inquiries and concerns.
- Address patient questions and concerns professionally and courteously.
Billing and Claims Management:
- Assist in answering any questions regarding insurance claim questions patients may have and work with other departments to resolve any issues.
- Respond to questions from our third-party insurance billing company to make sure claims are filed in a timely and accurate manner.
Patient Account Management:
- Contact patients with outstanding balances to discuss payment options and resolve any billing inquiries or disputes.
- Establish and maintain payment plans for patients in financial hardship, ensuring compliance with office policies.
Payment Posting:
- Accurately post payments received from patients and insurance companies to patient accounts.
- Reconcile payments against outstanding balances and identify discrepancies.
Collections and Follow-Up:
- Initiate collections efforts for overdue patient accounts through phone calls, emails, and written communication.
- Negotiate and arrange payment arrangements with patients as needed.
- Escalate delinquent accounts to management when necessary.
Credit Balances:
- Identify and resolve credit balances in patient accounts promptly.
- Process refunds to patients or insurance companies as required.
Reporting and Documentation:
- Maintain accurate records of all collection activities and correspondence with patients and insurance companies.
- Generate and analyze collection reports to track progress and identify trends.
Compliance and Regulations:
- Stay current on healthcare billing regulations, including HIPAA, and ensure compliance in all collection activities.
Qualifications:
- High school diploma or equivalent (some college coursework in accounting or healthcare administration is a plus).
- Previous experience in medical billing and collections, preferably in an optometrist or healthcare setting, preferred.
- Familiarity with insurance eligibility verification and pre-authorization processes.
- Ability to be on the phone for extended periods of time.
- Proficiency in billing and practice management software.
- Strong communication skills.
- Detail-oriented with excellent problem-solving abilities.
- Ability to work independently and meet deadlines.
- Sensitivity and empathy when dealing with patients' financial situations.
- Understanding of healthcare regulations, including HIPAA.
