Billing Specialist

PRIMARY DUTIESMaintain a current knowledge of insurance carrier and/or state program claims filing policies and proceduresVerify patient demographics and financial coverage; update as neededResearch and verify patient and/or insurance company and/or state program refunds/recoupmentsAdjust patients accounts to reflect changes in payment responsibilityVerify accuracy of information on paper medical claim forms and mail to selected insurance carriers and/or state programsResearch patient charges not automatically assigned to selected insurance carriers and/or state programs, make corrections and assign manuallyMaintain patient accounts; give GHC program discounts and/or other adjustments as neededAppeal service charges rejected by selected insurance carriers and/or state programs and resubmit amended claim formsProcess claims/vouchers as needed for insurance plans and/or state programsObtain pre-certifications, prior-authorizations, or referrals for special provider services as neededVerify motor vehicle or accident information with patient’s insurance carrierMaintain work ques with claim errorsAssist insurance carriers and/or state programs to acquire supplemental patient information needed to process claimsAssist patients to understand fees for services and billing processesAssist patients to make payment arrangements and find financial assistanceAssist outside providers and vendors to obtain physician billing informationAssist employees to understand policies and procedures related to billing mattersCommunicate and support training issues with billing staffComply with all regulations related to confidentiality of patient informationMaintain and/or create new payor and plans as neededAble to manage multiple priorities and manage stress appropriatelyCommunicates appropriately and clearly with a pleasant and professional manner to allDemonstrates excellent judgment in handling situations not covered by written or verbal instructionsDemonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respectMaintain certifications and website passwords as applicableOTHER DUTIESAssist in scheduling patient appointmentsProcess billing statements and balance notification letters to patientsAssist patients to make payments on owed balancesProvide follow-up on patient’s payment arrangementsAssist with daily mail dutiesProvide backup support for clerks and other billing staff as neededOther duties as assigned by supervisorPHYSICAL AND MENTAL REQUIREMENTS:Visual and auditory accuracyShift length – 8 hoursIndoor settingContinuous use of computer, calculatorLong periods of sitting and walkingFrequent use of telephoneFrequent use of stepladderContinuous repetitive grasping and manipulation of both handsContinuous conversational communicationOccasional reaching, standing, squatting, bending, kneeling, twisting and climbingOccasional carrying, lifting, pushing and pulling of up to 10 LbsInfrequent use of personal transportationWorking in a frequently noise environmentContinuously working in a tight areaUnderstand/carry out simple/detailed, oral/written instructionsMemorize and retain instructionsRead and interpret detailed specifications.REPORTS TO: Director of Billing ServicesEDUCATION: High School Diploma or Equivalent required, College Hours preferredSKILLS: Computer literacy, knowledge of ICD-10 CM/CPT coding, medical office billing and collection practices, federal/state/local financial assistance programs, strong interpersonal, oral, and written communication skills, excellent telephone, and customer service skills. #J-18808-Ljbffr