What are the responsibilities and job description for the Medical Billing Specialist position at ASSOCIATED RETINA CONSULTANTS?
About Us
Since 1974, Associated Retina Consultants has an experienced team of Arizona eye specialists to diagnose and treat your vision problem. Our focus is on the retina, macula, and the vitreous humor in the eye. We work hard every day to protect and save our patients vision, helping them lead better quality lives.
Position Summary:
We are looking for an organized, efficient Medical Billing Specialist with an eye for detail and high level of accuracy. The Billing Specialist is responsible for posting insurance payments, entering charges, and assisting patients with their accounts. Position requires accuracy, thoroughness, and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable, CPT codes and Dx codes.
Responsibilities:
- Work with personal information and maintain patient confidentiality
- Weekly and monthly reporting to executive director and billing supervisor.
- Verify the accuracy of all claims before submission and ensure all claims are submitted with a goal of zero errors and review claims and claims denials to ensure maximum reimbursement for services provided.
- Utilize monthly aging accounts receivable reports for follow-up on unpaid claims aged over 30 days.
- Review referrals and authorizations
- Respond to questions and complaints from patients or insurance companies
- Research and appeal denied claims.
- Read and interpret insurance explanation of benefits and respond to inquiries from insurance companies, patients, and providers.
- Other responsibilities as judgment or necessity dictate.
- Meet defined department goals and activity metrics.
- Initiate late payment notices to relevant parties
- Identify and bill secondary and/or third-party insurances.
- Follow set billing processes and procedures and follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO.
- Ensure patient information is accurate and complete and request any missing patient information.
- Create both paper and electronic copies of documentation
- Collect delinquent accounts by establishing payment arrangements with patients; monitoring payments; following up with patients when payment lapses occur.
Education and Experience:
- High School Diploma or Equivalent required.
- 2 years medical billing experience preferred.
- Knowledge of insurance guidelines including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
- Proficient in Microsoft Word, Outlook, Excel, and 10 key calculators.
- Basic knowledge of medical terminology, including CPT/ICD-10 coding.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Knowledge of medical terminology likely to be encountered in medical claims
- Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPAA).
Skills:
- Planning and organizing
- Attention to detail, accuracy, and efficiency
- Problem-solving
- Teamwork
- Multitasking
- Customer service
- Electronic Medical Records (EMR)
- Communication skills - verbal and written
- Integrity
Benefits: Medical, Dental, Vision, Life Insurance, Disability Insurance, Paid Holidays, Vacation and Sick Time and much more.
Physical Requirements:
- Prolonged periods sitting at a desk and working on a computer.
- Must be able to lift up to 15 pounds at times.
In office environment with controlled atmosphere. Possible exposure to staff or patients with communicable diseases and blood borne pathogens.
The Company has reviewed this job description to ensure that essential functions and basic duties have been included. It is intended to provide guidelines for job expectations and the employees ability to perform the position described. It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills, and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate. This document does not represent a contract of employment, and the Company reserves the right to change this job description and/or assign tasks for the employee to perform, as the Company may deem appropriate.
Associated Retina Consultants is an Equal Opportunity Employer.