JOB SUMMARY:

Ensures accuracy of data entry of daily charges to include implants as well generates electronic and paper insurance claims, patient statements and performs collection of outstanding insurance or patient balances.

QUALIFICATIONS:

Minimum two years' experience in medical billing required.

Knowledge of medical billing/collection practices required.

Coding certification preferred.

Computer experience required in Microsoft Office applications which include Outlook, Word and PowerPoint

ESSENTIAL FUNCTIONS:

• Monitors receipt of daily coding and performs charge entry ensuring accuracy of charges entered, modifier usage, implant coding and timeliness of filing insurance claims both on paper and electronic.
• Monitor and addresses all electronic scrubbing errors to ensure claims get to the payer timely.
• Initiates follow-up phone calls on accounts with an outstanding balance.
• Maintains standards to ensure systematic, consistent and timely collection follow-up.
• Initiates follow-up on accounts with outstanding balances that do not have appropriate payment arrangements.
• Works the Accounts Receivable report daily and ensures every outstanding account is worked a minimum of every 30 days.
• All notes regarding written and/or verbal communication on the account will be maintained in the comment file on the patient’s account and should include at a minimum the following:
  • Date of collection work
  • Telephone number of contact
  • Full name of contact
  • Location of contact (home, work, employer, insurance co.)
  • Complete summary of conversation to include check number and date of payment promise.
  • Next follow-up date based on payment promises.
• Works patient due accounts placing the initial follow-up call 14 days following the date of service. Subsequent follow-up calls should be made every 14 days until the balance is paid or until adequate payment arrangements are made according to policy.
• Makes recommendation to BOM for accounts aged 60 to 120 days without appropriate payment arrangements be sent to a collection agency.

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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.

The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to push/pull over 25 pounds on a regular basis.

The employee must be able to stand and/or walk at least five hours per day.

WORK ENVIRONMENT:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.