Accounts Receivable, Billing, Co-Payments, Communication Skills, Conflict Resolution, Customer Support/Service, Electronic Medical Records, Fax Machines, Fee Schedule, Healthcare Providers, High School Diploma, Insurance, Interpersonal Skills, Medical Billing, Medical Office, Medical Record System, Medical Terminology, Object Oriented Programming (OOP), People Management, Physical Demands, Polysomnography, Presentation/Verbal Skills, Spreadsheets, Telephone Skills, Time Management, Writing Skills
The Billing Specialist is responsible for providing exceptional customer service to patients and medical facilities. Keep daily patient flow timely as well as completing tasks and daily duties within the work shift.
- Working Patient's AR to include calling and collecting any patients' balances, sending collections letters and turning over to collections (Prince Parker) if no payment, payment plan or response has been made.
- Notify Prince Parker of any paid collection payments that have been made directly to the office.
- Filing all electronic and paper claims including office visits and sleep studies and to include correct prices, codes, modifiers, place of service, provider, etc.
- Verified credit on patient account to see if they are a true credit and applying to previous balance if needed, applying toward future visit if within the year or if not requesting a credit refund to practice manager for a refund to patient.
- Posting all insurance payments & Patient's payments either received electronic/CC or manual.
- Respond & work all messages and emails
- Check the fax que for any faxes related to Billing and complete as needed, such as cc payments from insurance companies.
- Answer and respond to all calls from staff, patients. and insurance regarding billing, claims, balances, or similar issues.
- Updated and verifying all electronic payments on spreadsheet have been received and posted.
- Follow up on any new changes from insurance companies including polices, claims address, etc. as needed.
- Work all insurance AR including calling, if necessary, for response or denial of claim. And to complete any claim appeals.
- Working and investigating any recoupments from insurance to validate if payment is due to ins.
- Schedule patient as needed
- Other related duties as assigned by manager.
Competencies:
To perform the job successfully, an individual should demonstrate the following competencies:
- Interpersonal skills-Focuses on conflict resolution and seek the highest degree of accountability. Listen to others with empathy and without interruption. Ability to manage interpersonal conflicts among patients, families, and others in a positive and constructive manner.
- Communication- Speaks clearly and professionally in positive or negative situations; writes/types clearly and informatively; listens and gets clarification; able to read and interpret written information. Ability to recognize and direct information to the appropriate health care provider and other staff members.
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
Education, Credentials, Certification, and/or Experience:
- High School diploma
- Previous work experience in a medical office as a biller or insurance specilist
- EMR/EHR Experience
- Medical terminology
- Comfortable using a computer for various tasks.
- Knowledge in insurance such as deductible, OOP, copays, etc.
- Knowledge of different types of insurance, fee schedules, and filing
- Knowledge, Skills and Abilities:
- Demonstrate ability to build and maintain solid working relationships with medical facilities
- Exhibits effective oral and written communication with staff, manager, patients, and referral source
- Must be highly self-motivated, flexible and service-oriented
- Builds relationships with patients, and referral sources
- Strong organization and time management skills
Working Environment:
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. Majority of time is spent in a typical service-oriented work environment and requires almost constant use of the phone and computer.
Physical Demands:
The physical demands described here are representative of those that must be met by an individual to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Regularly required to focus, see talk, and hear
- Regularly required to communicate with others in person, via phone, email or other means.
- Frequently required to sit, stand and walk
- Occasionally require to bend, stoop and left up to 25 lbs.