Small busy medical practice is looking for a Insurance/Billing Specialist. This is a full-time position, Monday through Thursday from 8:00 am – 5:00 pm, and Friday 8:00am -1:00 pm with some possible late nights. The ideal candidate will have a friendly disposition, a willingness to help others, and knowledge of medical terminology.

• Position Requirements:
• High school graduate or equivalent with good computer application experience, customer service and problem solving skills. Employee will have knowledge and experience with claims processing. Will possess an aptitude for accuracy, good judgment and initiative. Employee will have a clear understanding of all account or invoice level activities for analysis and problem solving tasks.
• Experience - Insurance billing and general office duty experience required.
• Licensure - Certified Coder
• Skills - Must have interpersonal skills necessary to deal effectively with patients and payer representatives. Ability to analyze information and think critically. Proficient in the use of Windows software.
• Physical and Mental Effort - Ability to work effectively in a fast-paced environment. Physical ability to sit, perform data entry and view computer screen for long periods at a time.

Environmental and Working Conditions:

• Works in a clean, well-lighted, air-conditioned environment. May be at risk for injury related to repetitive motion.

Position Summary:

This position is responsible for posting and monitoring payments from insurance, patient payments and obtaining authorizations for surgical procedures . The individual will respond to customer and payer inquiries and concerns, perform claims follow-up activities and perform special projects as directed. He/she will perform other related duties as needed to maintain department cost containment and efficiency and quality of performance.

Essential Functions:

The following description of job responsibilities and performance expectations is intended to reflect the major responsibilities of the job, but is not intended to describe minor duties or other responsibilities as may be assigned from time to time.

Demonstrates a commitment to the basic concepts of continuous quality improvement.

• Demonstrates courteous behavior towards all co-workers and maintains a positive guest relations approach with patient and payer representatives.
• Recognizes when others are in need of assistance, information or directions and offers to help when able, or finds someone who can.
• Contributes to the fluctuating staffing needs of the department by being flexible in own assignments and work schedules.
• Maintains patient, employee and center privacy and confidentiality at all times.
• Promotes a professional image by adhering to the established dress code.
• Answers telephone in a courteous manner.
• Maintains patient, employee, clinic and surgery center privacy and confidentiality at all times.

Communicates effectively, both verbally and in writing, to other members of the team.

• Shares pertinent patient information with office and clinical staff.
• Responds to patient/payer inquiries in a timely manner.
• Maintains open and positive lines of communication
• Utilizes proper chain of command
• Maintains emotional control and diplomacy at all times
• Uses verbal and non-verbal communication in a pleasant, professional manner.
• Communicates only factual information to employees, patients and physicians to avoid misunderstandings and undue stress.

Functions according to established department protocols and demonstrates knowledge of current policies and procedures.

1.Performs core functions associated with the job including but not limited to:

• Performs appropriate billing/payment posting functions as assigned.
• Performs tasks associated with secondary (subsequent) insurance claim submission, including copying, preparing and attaching EOB from primary payer as necessary.
• Ensures pertinent information relating to patient accounts and/or payer interaction is documented in the billing file.
• Processes account adjustments when applicable, including reviewing and resolving edits created by internal billing system and electronic transfer.
• Assists customers via phone or in-person with billing questions or issues.
• Follows up on unpaid or improperly paid claims as necessary.
• Anticipates potential billing/reimbursement problems and takes measures to prevent them.
• Masters all system computer functions applicable to duties and maintains proficiency.
• Reviews and monitors select accounts within the accounts receivable system, determines and performs appropriate collection actions to resolve account.
• Processes appeals and performs reimbursement analysis as directed by Practice Administrator.
• Data enters registration updates as necessary.

2.Recognizes own responsibility in ensuring that policies and procedures are adhered to throughout the facilities.

3. Responsible for daily deposits.

4. Responsible for running monthly sales tax report.

5.Participates in problem solving when QI issues are presented; formulating solutions and implementing them into daily processes.

Other Functions:

Develops leadership skills that demonstrate commitment to department, Clinic, Surgery Center, and own personal growth along with maintaining knowledge of current procedures and trends.

1.Functions as a resource person in own specialty area by:

• acting as a consultant to peers
• participating in the learning experience of new personnel.
• serving as a preceptor if opportunity arises

2. Assumes responsibility for own learning

• Increases competency by reading periodicals, newsletters and articles pertinent to the job.
• Attends continuing education program(s), seminar(s) or workshop(s) related to current area of responsibility and shares content with co-workers.
• Develops a personal plan to cultivate skills and will review it annually during the performance appraisal process.
• Maintains knowledge of current procedures and trends.

3. Participates in identifying and resolving problems within the department, Clinic and Surgery Center:

• Demonstrates a systematic, collaborative approach to problem solving while recognizing the inter-relationships between staff, patients and Surgery Center.
• Identifies areas of conflict and seeks resolution.
• Participates with team members in identifying problems and formulating reasonable solutions that benefit everyone.
• Provides written/verbal feedback to Practice Administrator and/or Doctors as requested.
• Recognizes stress in self and makes use of positive coping techniques.

Takes part in the Clinic and Surgery Center's program to promote the safety of self, and co-workers.

• Is able to demonstrate the knowledge of and adherence to safety and security guidelines.
• Reports real or potential safety problems that are associated with activities in their work area.

Complies with all company policies including the following:

• Consistently reports to work on time and begins work promptly and performs duties for entire scheduled shift.
• Maintains absentee rate within limits of status.
• Notifies appropriate personnel of absences and tardiness.
• Attends all mandatory in-services
• Reads new policies and documents as instructed

Full Time Benefits Included.

Job Type: Full-time

Pay: $19.00 - $22.00 per hour

Benefits:

• 401(k)
• Disability insurance
• Employee discount
• Health insurance
• Life insurance
• Paid time off

Schedule:

• 8 hour shift
• Monday to Friday

Education:

• High school or equivalent (Preferred)

Experience:

• ICD-10: 3 years (Required)
• Medical Billing: 3 years (Required)

Work Location: In person