Medical Billing Representative

Under the supervision of the Billing Manager and the Revenue Cycle Manager, this staff position is responsible for many multi-faceted tasks within the Billing Department. These tasks include all aspects of patient accounts, claims filing, credit refunds to insurance and assisting front office staff with issues related to verifying eligibility and benefits.

Responsibilities & Duties:

The billing department has a wide range of responsibilities and must ensure that team members are appropriately cross trained to ensure that the department operates consistently and without interruption. In the interest of continuity, the Medical Billing Representative responsibilities may include, but are not limited to, the following:

· Prepare patient statements daily and send files to statement processing group.

· Serve as the liaison to the collection agency for reporting patients.

· Answer patient phone calls regarding patient accounts.

· Posting payments from patients.

· Processing all retina copay assistance claims to Chronic Disease Fund and other retina copay assistance programs.

· Billing claims, both electronically and on paper.

· Assist in working denials from insurance companies.

· Accurately posts within the management information system.

· Use provider portals efficiently for tracking claim status and verifying eligibility and benefits.

· Assists with training in the front offices as needed.

· Reviews the surgery schedule for necessary financial arrangements, payer issues and for procedures requiring prior authorization.

· Enters charges for surgeries.

· Posts insurance payments. Reviews and completes follow up on all explanations of benefits and other insurance company communications when applicable.

· Balances the daily sheet to prepare for deposit.

· Collects pre-pays for SEC surgeries.

· Interacts with surgery center staff regarding patient business matters.

· Assists billing department coworkers with duties as needed.

· Contact insurance carriers through telephone or written communication when accounts are sixty (60) days old and no response has been received from the insurance carrier or patient. Appropriately documents all written and telephonic correspondence in designated practice management system.

· Requests payment on balances as indicated by the aging report. Using influence and supportive techniques, collects past due account balances via electronic payment or other acceptable methods.

· Works to establish payment plans with patients who are unable to pay the entirety of their balance at the time of collection. Documents established payment plans within the electronic practice management system. All payment plans will be established with reasonable terms and a succinct payment schedule.

· Reviews the account aging analysis report to determine the accounts requiring immediate attention (after 60 days and over $500 balance are priority). These accounts are to be identified and addressed with priority.

· Maintain daily communication (written and verbal) with the Billing Supervisor and Revenue Cycle Manager. Provide regular updates on problem accounts and plans for resolution of such accounts.

· Duties and responsibilities may be added, deleted, or changed at any time. At the discretion of management, formally or informally, either verbally or in writing.

· Other duties as assigned.

Education/Training/Experience:

· High School Diploma or General Education Development (GED).

· At least one year of medical services experience in a health care organization.

· Experience in basic medical coding and medical insurance billing is preferred.

Job Type: Full-time

Pay: $16.21 - $22.69 per hour

Expected hours: 40 per week

Benefits:

• 401(k)
• 401(k) matching
• Dental insurance
• Employee assistance program
• Employee discount
• Flexible schedule
• Flexible spending account
• Health insurance
• Health savings account
• Life insurance
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift
• Day shift
• Monday to Friday

Ability to Commute:

• Morgantown, WV 26505 (Required)

Work Location: Hybrid remote in Morgantown, WV 26505

Salary : $16 - $23