Billing Department Lead

Sports medicine physician practice looking for a highly motivated individual to join the Business Office department as the Billing Department Lead

DUTIES INCLUDE, BUT ARE NOT LIMITED TO :

• Liaison between Billing Department staff and Clinical Directors
• Liaison between Billing Department staff and IT support
• Monitor weekly billing productivity to ensure billing is submitted timely
• Review weekly POD billing and AR reports
• Monitor billing of all new services
• Assist with POD claims projects as needed
• Approve write-off requests, refund requests, and 3rd party settlement requests
• Assist in monthly reporting to Directors, CEO, and Partners
• Timecard management, PTO requests and approvals
• Assist in interviewing, hiring, disciplinary actions, staff reviews and performance evaluations
• Train new Billing Department staff
• Coordinate staff and call coverage
• Provide coverage and support as needed
• Manage patient complaints Compliance
• Responsible for charge and payment entry within Electronic Health Record. Coordinates and clarifies with providers, when necessary, on information that seems incomplete or is lacking for proper account / claim adjudication.
• Responsible for correcting, completing, and processing claims for all payer codes.
• Analyze and interpret that claims are accurately sent to insurance companies.
• Perform follow up with Medicare, Medicaid, Medicaid Managed Care, and Commercial insurance companies on unpaid insurance accounts identified through aging reports.
• Process appeals online or via paper submission.
• Assist in reconciling deposit and patient collections.
• Assist with billing audit related information.
• Process refund requests.
• Communicate with billing and credentialing coordinator to identify and resolve audit review issues.
• Process billing calls and questions from patients and third party carriers.
• Answer / respond to correspondence related to patient accounts. Is available to answer billing and changes related inquiries by patients, staffs, Managed Care Organization, etc.
• Communicate daily with internal and external customers via phone calls and written communications.
• Research, record findings, and communicates effectively with Manager to achieve optimum performance.
• Pursue and participate in education to remain current with changes in the Healthcare industry.
• Maintain patient confidence and protects medical office operations by keeping patient information confidential.
• Contribute to team effort by accomplishing related results as needed.
• Promote effective working relations and work effectively as part of a team to facilitate the department's ability to meet its goals and objectives.
• Demonstrate respect and regard for the dignity of all patients, families, visitors, and fellow employees to insure a professional, responsible and courteous environment.
• Attend on-site / off-site community engagement activities and on-site / off-site clinic events as needed.
• Perform other duties as assigned

Qualifications :

Education : High School diploma or GED required

Experience : Minimum of 1 year experience as a medical biller / coder

Experience with electronic scheduling system and electronic medical records (EMR) required.

Familiar with medical terminology