What are the responsibilities and job description for the Medical Billing and Collection Specialist position at R-Finity Solution INC?
R-Finity Solutions INC is currently looking for Part time/Full time candidates with Billing, Collections, and credentialing experience.
Billing and Collections:
- Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.
- Reviewing patient bills for accuracy and completeness, and obtaining any missing information.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle time frame.
- Calling insurance companies regarding any discrepancy in payments if necessary
- Reviewing patient accounts and follow-up on monthly basis
- Answering all patient or insurance telephone inquiries pertaining to assigned accounts.
- Obtaining referrals and pre-authorizations as required for procedures
Credentialing:
ESSENTIAL FUNCTIONS INCLUDE BUT ARE NOT LIMITED TO:
- Compiles and maintains current and accurate data for all providers.
- Completes provider credentialing and re credentialing applications; monitors applications and follows-up as needed.
- Maintains knowledge of current health plan and agency requirements for credentialing
- Sets up and maintains provider information in online credentialing databases and system.
- Tracks license and certification expiration for all providers to ensure timely renewals.
- Ensures practice addresses are current with health plans, agencies and other entities.
- Processes applications for appointment and reappointment of privileges to The Doctors Clinic (ASC).
- Maintains ASC appointment files, and information in credentialing database.
- Audits health plan directories for current and accurate provider information
Job Types: Full-time, Part-time
Work Location: In person