What are the responsibilities and job description for the Billing Insurance Analyst I position at Tidewater Physicians Multispecialty Group P C?
Position Summary
The Billing & Insurance Analyst I is responsible for daily operations related to the billing of primary and secondary claims and insurance follow up for their assigned location(s); coordinates with staff to ensure timely billing and follow up for claim denials. The Billing & Insurance Analyst I will ensure all adjustments are minimal and accurate. The analyst will assist with identifying trends, account reconciliation, and answering questions related to billing.
Major Duties and Responsibilities
- Investigate insurance denials and make necessary corrections to bring claim resolution.
- Ensure the correct primary and/ or secondary insurance was billed
- Prepare and submit appeals and or medical records to insurance companies
- Assist with identifying trends, aberrations and concerns related to billing and payer denials and communicates concerns to management.
- Ensure that payments and adjusted are posted per the EOB
- Responsible for running detailed A/R reports
- Work with the coding team to resolve coding related denials
- Respond to correspondences from payers in a timely manner.
- Assist patients with phone inquiries related to billing.
- All other duties as requested by the Manager.
Knowledge, Skills and Abilities
- Knowledge of insurance payers, including commercial and government payers.
- Analytical and problem solving skills to allow efficient resolution of insurance payment issues.
- Knowledge of electronic health record.
- Knowledge of insurance follow-up to ensure proper reimbursement.
- Ability to use website based insurance systems.
- Knowledge of Microsoft Office applications.
- Knowledge of medical terminology
- Ability to work scheduled hours as defined in the job offer.
- Ability to establish/maintain effective working relationships with multiple departments.
- Ability to read and understand oral and written instructions and follow written protocols.
- Effective communication.
- Ability to work independently.
- Time management skills
Education / Training / Requirements
- High school diploma or college degree
- Experience in medical billing and/or claims follow up
Physical Demands
- Ability to stand and walk for limited periods of time.
- Ability to sit for extended periods of time.
- Ability to climb or balance for limited periods of time.
- Ability to occasionally reach, bend, stoop and lift up to 30 lbs. *
- Ability to grasp and hold up to 25 lbs.*
- Ability to hear normal voice level communications in person or through the telephone.
- Ability to speak clearly and understandably.
- Ability to smell.
Success Factors
- Alignment with Company Mission and Core Values
- Excellent Time Management/Organized
- Open Communication/Positive
- Goal Driven
- Excellent Customer Service
- Juggles Multiple Priorities
- Accuracy and Attention to Detail
- Accomplished in word processing and worksheet utilization
All statements are essential functions of the position unless identified as non-essential by an asterisk (*).
