The Billing Specialist /Surgery Scheduler is responsible for finalizing/reviewing the selected charges that are billed to represent patient visits in a timely manner as dictated by policy and best practice. Also, appropriately selecting add-on charges or quality codes as applicable based on information contained within the patient’s medical record and creating claims within the practice management system (Athena, Cerner, etc.) This position requires a working knowledge of insurance plan details and requirements including, but not limited to: pre- authorization processes, coverage exclusions, service (benefit) maximums, referral processes, medical necessity, appeals, etc. Duties relative to processing adjustments according to policy may also be required. The Billing Specialist/Surgery Scheduler is required to obtain information and knowledge as required from insurance payers via web tools, newsletters, phone conversations, etc. to adequately perform their duties as assigned. Additionally, in an effort to keep the accounts receivable current, this position may require frequent communications with patients and/or their family members for the purpose of obtaining information, requesting assistance in resolving insurance issues, or resolving outstanding balances on the account. This position requires attention to detail and compliance with all Federal, State, and other payer billing guidelines. The Billing Specialist/Surgery Scheduler works closely with the Physicians during the clinic to meet with patients and schedule surgery. Advise patients of surgery prep and insurance benefits, copays and deductibles. Schedules patients for postoperative vistis.

Required Education: Minimum high school diploma/GED
Preferred Education: Associates Degree and/or Technical School for Medical Billing/Coding

Preferred Experience: 4 (four) years Medical Claims processing, Physician Practice setting
Preferred License/Registration/Certification: CPB Certified Biller through AAPC, CMIS through PMI, CMRS through ABA

Computer Skills Preferred:

Google Suite including Gmail, GDrive, GSheets, GCalendar, etc.
Microsoft Office Suite including Word, Excel, Power Point, and Visio
Kronos, Athena, and the ability to learn multiple new systems being used in the organization to perform daily operational activities