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 ResponsibilitiesBILLING: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 paymentsUpdate 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.