Medical Billing and Collections Specialists

Responsibilities

• Assesses patients’ financial ability, determines ability to pay, advises patients to contact insurance company with questions regarding benefits.
• Explains financial liability, puts credit card on file for payment, negotiates payment arrangement, and resolves any confusion the patient may have about their financial obligations to the practice.
• Processes claims, submits claims, posts payments, appeals denied claims.
• Researches and corrects denied claims for refiling.
• Creates estimates for patient payment plans, creates and sends statements, reviews statement report for address errors.
• Reviews self-pay balances, precollection accounts, and collection accounts, confirms and collects deductibles for Surgery, Office procedures, and Balloons.
• Accepts payments over the telephone, releases accounts “in collection status” once balance is paid.
• Attends webinars for insurance updates, identifies trends and billing issues, and involves the supervisor for resolution.
• Answers calls from patients, insurance companies, and other staff members.

Qualifications/Skills

• High School Diploma or equivalent required.
• Advanced education in medical billing preferred.
• Previous experience working in accounts receivable/billing and collecting in a healthcare setting.
• Experience with insurance billing.
• Ability to analyze cost/reimbursement of accounts.
• Medical Terminology knowledge including CPT and ICD-10 and coding preferred.
• Demonstrates tact to effectively deal with patients, physicians, and other employees in the practice.
• Possesses knowledge and experience with modern office procedures, office equipment, and medical terminology.
• Proficient with computers, electronic health records, and excellent data entry skills.
• Understands healthcare concepts as they pertain to registration and insurance.

Position Requirements

• Minimum 3 years in physicians’ office performing patient billing and collections required.
• Previous computer skills in Physician Practice Management System and/or Windows application.
• Ability to analyze and review insurance and patient claims.
• Ability to multitask using EMR system and insurance websites.
• Medical Terminology including CPT4 procedure coding, ICD10 diagnostic coding, and HCPCS coding preferred.
• Thorough understanding of billing requirements for governmental and private payers.
• Possesses the tact to deal effectively with patients, physicians, and other employees in the practice.
• Possesses accurate data entry skills.
• Possesses strong oral and written communication skills.