Company Overview:
Pediatric Group Associates specializes in the comprehensive medical care of children from birth to college. Pediatric Group Associates is a division of CareCloud Practice Management a subsidiary of CareCloud Inc.
Job Summary:
The general responsibility for providing daily medical billing, collection and customer service efforts on patient accounts, to include charges and payments into computer system ensuring resolution of reports from the billing system, claims intermediary and third-party payors.
Essential Duties and Responsibilities
BILLING:

• Experience billing and coding pediatric services.
• Receive and verify documents required for billing and follow-up purposes.
• Process primary, secondary, and tertiary claims according to respective regulations and policies.
• Correspond with third-party representatives, as necessary, to complete claims processing and/or resolve problem claims.
• Respond to patient and third-party inquiries via the telephone or written correspondence in a timely manner.
• Interface with other departments, when appropriate, to obtain information necessary to process or resolve claims.
• Follow up daily on post-processing activity including, but not limited to, rejected billings, adjustments, re- billing, and unpaid claims.
• Return documents in error to appropriate individuals for proper completion.
• Customer Service greets patients and visitors in a prompt, courteous and helpful manner.
• Checks in patients, verifies and updates necessary information in the medical record.
• Receives payments from patients and issues receipts. Reconciles daily cash.
• Schedules appointments and follows office scheduling policies. Follows up to make sure all patient and insurance information is current, correct, and in order, confirms patient appointments for the following day.
• Answers telephone, screens calls, takes messages and provides information.
• Files charts, coordinates lab work, physician’s report, sorts/delivers mail, medical records and other correspondence.
• Maintains work area and lobby in neat, orderly manner.
• Availability to work Saturday hours as scheduled.
• Attends meetings as required.
• Performs related work as required.
• Ability to prioritize tasks and to delegate when appropriate.
• Maintains patient confidentiality and complies with all HIPAA regulations.
• Additional duties as assigned to meet the needs of business operations.

COLLECTION:

• Coordinate with medical office staff to ensure applicable collection of co-payments and outstanding balances from patients at time of service.
• Post payments (insurance and self-pay) to patient accounts.
• Review and reconcile electronic payments
• Update file maintenance as requested (referring physician, payor, etc.)
• Make adjustments to patient accounts according to written policies and procedures.
• Research and process complex charge corrections.
• Prioritize work received and complete in a timely manner.

CUSTOMER SERVICE:

• Perform billing clerical duties, including review and verification of patient account information against insurance program specifications,
• Resolve routine patient billing inquires and problems follow up on balances due from insurance companies, and type invoices to insurance companies.
• Enter data electronically to process charges, payments, denials and adjustments.
• Analyze and code procedures and diagnosis using ICD-10 and CPTcodes.

Supervisory Responsibilities: None
Education and Experience:

• Knowledge of front-office procedures. Knowledge of practice cash payment policies and procedures.
• Ability to enter patient demographic information in computer in timely and efficient manner.
• Greet patients and answer the telephone in a courteous and helpful manner.
• Excellent verbal and written communication skills.
• Ability to sort and file materials correctly by alphabetic or numeric systems.
• Ability to establish and maintain effective working relationships with patients, co-workers and vendors.
• Ability to multi-task.
• High school diploma or GED.
• Prefer one-year work experience, preferably in a medical office setting.
• Knowledge of medical terminology desirable.
• Word processing and computer experience required.

Equipment Used:
Computer, telephone, fax machine, photocopier, and other standard office equipment.
Interaction:
Work is performed in reception area. Involves frequent contact with patients. Interaction with others is constant and interruptive. Contact involves dealing with sick children, exposure to communicable diseases, toxic substances, and medicinal preparations. May require individuals to work in outside elements to complete necessary job duties and responsibilities.
Physical Requirements:
Work may require frequent mobility and/or sitting for long periods of time; also stooping, bending and stretching for files and supplies. Occasionally lifting files or papers weighing up to 20 pounds. Other responsibilities as assigned by Practice Manager.
EEO Statement: CareCloud is committed to equal employment opportunity for all qualified individuals. We are committed to complying with all federal, state, and local laws providing equal employment opportunities,and all other employment laws and regulations. CareCloud prohibits discrimination against employees and applicants because of race, religion, color, gender (including gender or sexual identity or expression), age, national origin, ancestry, marital status, sexual orientation, physical or mental disability, medical condition including genetic characteristics, genetic information, veteran status, or other characteristics protected by applicable law.
Physical Demands: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. While performing the duties of this job, the employee is regularly required to talk or hear. The employee frequently is required to stand; walk; use hands and fingers, handle or feel; and reach with hands and arms. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus. This position requires the ability to occasionally lift office products, equipment, and supplies, up to 20 pounds.
ADA Statement: CareCloud is fully compliant with the ADA and will provide reasonable accommodations to enable individuals with disabilities to perform essential job functions under the guidance of the ADA.
Other Duties: Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that you may be asked by your managers to perform other duties.
Benefits:
CareCloud recognizes the importance of benefits and wellness for employees and their families. In addition to time off to support work-life balance and enjoyment, we offer a comprehensive benefits package designed for employees’ individual needs (including domestic partners).

• Healthcare – A choice of medical plans designed to meet your individual needs
• Dental & vision
• 401(K)
• Flexible spending accounts (health & dependent care)
• Company-paid life insurance (accidental and supplemental coverage at low cost)
• Company-paid Short and Long term disability
• Voluntary benefits
• Flexible PTO and Paid Holidays