JOB TITLE: Medical Billing Specialist

GENERAL SUMMARY OF DUTIES: Responsible for all aspects of patient accounts: billing, collections, accounts receivable, including but not limited to processing, code editing, & monitoring the submission of all surgery center claims – electronic & paper. Respond to patient and payer inquiries and concerns, perform claims follow-up activities including accounts receivable, determining patient financial responsibilities, posting payments, & performing special projects as directed. Front Desk duties as needed.

SUPERVISION RECEIVED: Reports to the Administrator

SUPERVISION EXERCISED: None

ESSENTIAL FUNCTIONS:

• Medical Billing for Orthopedic, Podiatry, ENT, Interventional Radiology, & Plastic Surgery specialties.
• Process and post accurate payments on a daily basis.
• Monitor charges and payments for claims including billable supplies and implants following payer contracts.
• Work outstanding Accounts Receivables, including self pay and insurance claims.
• Assist patients with billing questions & explain EOB's.
• File claims (Paper & Electronic) to insurance company timely.
• Maintain up to date CPT, ICD-10, and HCPCS coding.
• Distributes coding information to appropriate personnel.
• Continue educating on payer policies.
• Verify patient’s insurance information & communicate patient's financial responsibility prior to date of service.
• Review reimbursement from third party payers to ensure accurate payment.
• Process, post and photocopy patient and reimbursement checks.
• Monitor reimbursement of selected procedures on a continuous basis and identified changes in reimbursement patterns.
• Maintains reimbursement/billing profiles from third parties and compares with center fees and reimbursement.
• Stays current with changes in reimbursement regulations, notifies and trains staff of significant changes.
• Participates in professional development activities.
• Maintains strictest confidentiality.
• Front Desk / Registration duties as needed.
• Performs other related duties as assigned by supervisors

The job holder must demonstrate competencies applicable to the job position.

EDUCATION: High school graduation or GED. Associate degree in business or administration preferred.

EXPERIENCE: Preferred at least 2 years experience (minimum 1 year) with billing and/or reimbursement activities, CPC preferred. Experience with or Vision software helpful, but not required.

KNOWLEDGE:

• Knowledge of medical billing / coding policies and procedures and reimbursement practices.
• Knowledge of accounts receivable practices and medical business office procedures.

SKILLS:

• Skill in using computer programs and applications.
• Skill in identifying and resolving complex coding/insurance issues.
• Skill in establishing and maintaining effective working relationships with patients, medical staff and the public.

ABILITIES:

• Ability to multi-task.
• Ability to communicate information effectively with patients, medical staff and others.
• Ability to examine documents for accuracy and completeness.
• Ability to work effectively with co-workers as a team member.
• Ability to communicate effectively and clearly.

PHYSICAL/MENTAL DEMANDS: Requires sitting and standing associated with a normal office environment. Manual dexterity for using a calculator and computer keyboard with repetitive motions.

ENVIRONMENTAL/WORKING CONDITIONS: Normal office environment.

This description is intended to provide only basic guidelines for meeting job requirements. Responsibilities, knowledge, skills, abilities and working conditions may change as needs evolve.

Job Type: Part-time

Pay: From $18.00 per hour

Expected hours: 20 – 30 per week

Schedule:

• Monday to Friday

Work setting:

• Ambulatory surgery center
• Office
• Private practice

Experience:

• Medical Billing: 1 year (Preferred)

Work Location: In person