What are the responsibilities and job description for the Medical Billing Specialist position at Primary Care Partners Inc?
Medical Billing Specialist
- We pay for 100% of your health insurance premium.
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We offer paid vacation and sick time.
Primary Care Partners strives to maintain a positive work life balance for every individual.
Position is responsible for patient account management duties. Position interacts with patients both in-person and via phone and exceptional customer service skills are required. Duties include: entering charges and payments, auditing patient accounts for accuracy, verifying account demographic and billing information to secure payment for services rendered, assisting patients with establishing budget payments, accepting patient payments and processing, working past due accounts for collections, and mailing patient correspondence for billing purposes.
Duties/Responsibilities:
- Accurate guarantor demographic and insurance information
- Creating accounts for new patients
- Determining current insurance
- Verifying patient insurance eligibility via insurance websites or calling patients
- Adding/Removing insurance from account
- Updating patient demographics through information collected on the automated patient intake platform (Phreesia)
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Patient customer service for - telephone and in person
- Taking up to 40 calls per person per day
- Helping patients understand their statements, deductibles, copays, coinsurances
- Taking payments over the phone
- Mailing patient documents
- Address account issues from patient correspondence or incoming calls
- Monitor and correct duplicate accounts
- Split family accounts to individual accounts
- Request refunds for accounts with a negative balance from supervisor
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Charge Entry
- Reviewing submitted charges from providers, nursing staff and lab technicians for correct billing for 9 clinics for all insurances including self-pay
- Researching and auditing charts for missed charges
- Adding/Removing CPT, ICD10 and modifier codes as appropriate
- Running validation and verification reports on charges entered
- Working untracked encounter reports
- Map appropriate diagnosis to charge
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Payment and adjustment posting
- Posting insurance payments and adjustments both electronically and manually with correct remittance advice and remark codes, transferring balances to patient
- Posting patient payments
- Posting payments collected at front offices
- Researching denials and aging
- Communication with insurance companies on denials, reprocessing claims, eligibility confirmation
- Submitting corrected claims to insurance companies
- Reviewing accounts for credits, moving credits to balances on accounts and issuing refunds to patients and insurance companies
- Reviewing accounts for small, uncollectable balances and making adjustments as necessary
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Processing Patient Statements
- Submitting Patient statements to clearing house
- Validating claims
- Printing claims for paper submission
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Insurance Claim Submission
- Submitting claims electronically to insurance companies
- Reviewing failed claims from clearing house for missing coordination of benefits information, incorrect policy identification numbers, etc
- Reviewing rejected claims from insurance companies, correcting claims and resubmitting claims
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Daily Close, Monthly, Yearly & Deposit
- Balancing payments for billing office
- Balancing payments from 9 different clinics
- Submitting check payments electronically to bank
- Creating deposit for cash payments
- Running monthly/yearly reports on charges, payments, adjustments, refunds
- Collection Account Management
- Contact patients by phone when accounts are past due
- Process bankruptcy notices
- Process affidavits from collection agency
- Credit counseling arrangements
- Post payments from collection agency
- Maintain past due accounts for warnings, pre-collect, collections and discharge
- Communicate with collections agency regarding paid/completed accounts
- Maintain cash box and keep log
- Process NSF patient checks
- Process post office notifications for change of address
- Process Bank of Colorado loans and buy backs
- Process statement hold report
- Process deceased accounts
- Process payroll deductions for employees and maintain spreadsheet
- Front Office Support
- Handle all internal clinic calls
- Answer any billing or insurance questions from front desk staff at all locations
- Enter in any new insurances
- Verify eligibility for new insurances
- Training for front desk staff in adding/updating/removing insurance
- Manage tasks sent from front desk for self-pay patients when charges are not ready at the time of check out
- Call patient to collect self-pay charges when charges have been entered
Work Experience:
Formal billing training or appropriate work-related experience. High traffic phone experience preferred.
Education Requirements:
High School Diploma
General Requirements:
Exceptional customer service skills, collection experience, good communication skills, medical terminology preferred.
Work Experience:
Formal billing training or appropriate work-related experience. High traffic phone experience preferred.
Education Requirements:
High School Diploma
General Requirements:
Exceptional customer service skills, collection experience, good communication skills, medical terminology preferred.
