Billing Office Representative

JOB SUMMARY

The Business Office Billing Representative is responsible for the follow up of all insurance payment posting and personal payments, taking adjustments, Posting insurance denials. Working various reports, handling billing and patient calls as required, processing refunds and working collection accounts, referring patients for assistance and setting up payment plans and other duties as assigned or needed.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following. Other duties may be assigned.

• Posts all insurance checks and adjusts write-offs as required.
• Review Fee schedules for any incorrect payments or contract issues
• Posts patient payments (checks, credit cards, care credit) from incoming mail or phone.
• Enter and post all insurance denials and posts with the appropriate reason codes.
• Answers patient calls on Billing Q for account and billing questions
• Monitors Biling Q Voicemail, Patient Portal, Billing task and follows up appropriately
• Send tasks to appropriate department (clinical, optical, front office) to obtain additional information or to correct diagnosis/procedure code information.
• Sends FYI tasks to staff for training purposes.
• Answers incoming calls from patients, staff, insurance companies, and other medical facilities regarding insurance and/or billing concerns.
• Assists patients with setting up payment plans.
• Reviews and completes a variety of Business Office Reports.
• Follows up on any patient concerns and resolves any patient issues or completes patient complaint forms for follow up.
• Possesses knowledge of CPT and ICD-10 codes
• Works credit balance reports and processes refunds.
• Processes funds for copay assistance programs.
• Fills out Income Verification Forms for Low Income Housing
• Reviews and enters surgery charges for the ASC and professional fees.
• Reviews unapplied payments report and applies to account balances.
• Processes and reviews statements
• Completes daily balance sheets and send all paperwork to accounting 
• Organizes insurance company EOBs for filing or downloads.
• Processes and posts payroll deduction payments for employee accounts.
• Monitors and sends collection agency accounts, payments and general correspondence.
• Processes and opens incoming mail, sends outgoing mail, and handles returned mail.
• Posts medical records charges on patient accounts.
• Posts professional charges for J. Iverson Riddle.
• Reviews all emails.
• Scans checks for deposits.

Performs other duties as required.            

QUALIFICATIONS                               

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Individuals must have knowledge of medical insurance, excellent communication and organizational skills, proficient on most software applications and be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION and/or EXPERIENCE

Associate’s Degree in related field preferred; one year certificate from college or technical school; or three years or more related experience and/or training; or equivalent combination of education and experience.

LANGUAGE SKILLS

Ability to read and comprehend simple instructions, short correspondence, and memos.  Ability to write simple correspondence.  Ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.

MATHEMATICAL SKILLS

Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals.  Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY

Ability to apply common sense understanding to carry out detailed but uninvolved written or oral instructions.  Ability to deal with problems involving a few concrete variables in standardized situations.

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.  Specific vision abilities required by this job include ability to adjust focus.

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.

The noise level in the work environment is usually quiet.