Medical Billing Specialist - Plastic Surgery Office

OPPORTUNITY

Ohio Plastic Surgery Specialists is seeking an experienced, results-oriented Medical Billing-Administrative Specialist to add to our growing team. Our small but very busy Practice, led by renowned plastic and reconstructive surgeon, Dr. Walt Bernacki, is well-known throughout central Ohio for its exceptional patient care and life-changing surgical and non-surgical outcomes. Every member of our family-like team is valued and recognized for the contributions they make to our Practice as well as the positive impact they have on the lives of our patients.

JOB DESCRIPTION

The Medical Billing-Admin Specialist’s primary responsibility is to maximize the Practice’s cashflow by minimizing accounts receivable. Specific duties and responsibilities include, but are not limited to, the following:

Billing

• Work with reception to regularly collect and update (in EMR) patient insurance information and demographics.
• Create all bills in EMR per established SOP.
• Ensure first-time claims are clean (without error that could or do result in rejection).
• Monitor claims submissions, resolutions and re-submission activities of 3rd party biller and escalate issues in order to meet established success metrics.

Accounts Receivable

• Resolve all rejected claims and communicate resolutions to 3rd party biller within one week of notification.
• Review patient accounts for possible assignment to collections; send past due accounts to collections per SOP.
• Recommend changes to fee schedules to maximize overall revenues.

Administrative

• Regularly audit and maintain patient supporting documentation files, insurance information, and demographics in EMR.
• Ensure pre-determinations/pre-certifications are conducted, status of such is communicated to patient, and all pre-authorization information is accurately captured in the EMR.
• Reconcile and post all patient and insurance payments, EOBs in EMR in timely manner (weekly).
• Oversee performance of 3rd party biller; report any concerns to supervisor.
• Receive and deposit all cash receipts daily.
• Balance daily batches and reports.
• Ensure that Provider(s) maintain current credentials and licenses; monitor upcoming renewal dates and assist in completing required steps to maintain their credentials.
• Add/update service codes and pricing in EMR.

Patient-facing

• Research and respond to patients by phone and/or in writing regarding billing inquiries/issues/complaints.
• Prepare Good Faith Estimates; provide additional explanations.
• Cover front desk and check in and check out patients on occasion.

Operational

• Maintain up-to-date list of the Practice’s account numbers, passwords, etc.
• Establish and document processes (SOPs) for own areas of responsibility (billing, collections.
• Ensure Provider and Practice credentials are up to date and accurate.
• Ensure Provider Enrollments are up to date and accurate with each payer.
• Constantly streamline billing procedures and processes to ensure clean billing and timely payments.
• Open and close office.

Reporting

• Reconcile receipts in EMR with 3rd party biller/clearinghouse and bank accounts on weekly basis.
• Perform hard close in EMR at the end of each fiscal month.
• Prepare financial reports for Office Manager and CPA.
• Review and analyze payments and adjustment history, by payer, to ensure the Practice is achieving maximum reimbursement for services provided.

Other

• Participate in educational activities and attend staff meetings.
• Maintain strict confidentiality; adhere to all HIPAA guidelines/regulations.
• Assist in development and communication of SOPs throughout the Practice to improve accuracy and understanding or processes.
• Participate in a variety of clerical duties, including telephone reception, mail distribution, and other routine Practice functions.
• Other duties as assigned.

REQUIRED QUALIFICATIONS

• Minimum 5 years’ experience successfully overseeing billing and accounts receivable for medical practice.
• Proficient in medical coding.
• Experience with Provider credentialing.
• Highly proficient in Microsoft Office applications (Word, Outlook, Excel, PowerPoint).
• Proven ability to create and navigate spreadsheets, make calculations, etc.
• Proficient using Nextech, Epic, Praxis EMR or other EMR/EHR software.
• Excellent problem-solving skills: ability to arrive at and present win-win solutions.

PREFERRED QUALIFICATIONS

• Associate’s or Bachelor’s degree in business administration, finance or accounting or equivalent combination of education and experience.
• Billing experience in Plastic Surgery practice.
• Experience working in Nextech.
• Experience working with third-party billers.

PHYSICAL REQUIREMENTS AND WORK ENVIRONMENT

• Spend approximately 90% of time sitting at a desk, looking at a computer monitor, typing on a keyboard, talking on a phone handset or headset.
• Spend approximately 10% of time maneuvering between offices, greeting patients in the waiting area, answering incoming phone calls, and cleaning and tidying various areas and rooms.
• Ability to safely lift boxes of files or supplies weighing up to 25 pounds.

Job Type: Full-time

Pay: $45,000.00 - $55,549.00 per year

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Health insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Experience:

• Medical Billing: 5 years (Required)
• EMR systems: 5 years (Preferred)
• Microsoft Excel: 5 years (Preferred)

Ability to Relocate:

• Columbus, OH 43230: Relocate before starting work (Required)

Work Location: In person

Salary : $45,000 - $55,549