Medical Office Specialist II-BRFMC

JOB FUNCTIONS

• Answers telephone, greets visitors and schedules appointments.
• Maintains master scheduling program for all areas and makes appointment schedules for all patients, via computer system according to established procedures.
• Captures transportation needs of patients as needed.
• Coordinates insurance coverage with patients, insurance company, and Business Office as indicated.
• Communicates special patient needs to appropriate staff.
• Enters patient charges, completes chart maintenance and provides a variety of clerical support functions.
• Enters charges accurately on the same day it is incurred.
• Captures and coordinates charge data functions according to established procedures.
• Typing and proofreading a variety of material (e.g., letters, forms, reports, etc.) from rough draft and corrected copies.
• Maintains accurate and current files of all patient records, correspondence, reports, and information, as required.
• Forwards completed discharged charts to Medical Records according to established procedures.
• Prepares patient folders and files patient information appropriately, copies charts as approved by Medical Records, faxes and files a variety of materials.
• Mails patient evaluations, progress notes, prescriptions, etc., and follows-up on all correspondence within defined time lines.
• Performs billing functions to ensure proper billing and collections.
• Identifies and records required billing information according to insurance carrier requirements with 100% accuracy.
• Completes billing information accurately.
• Processes claims electronically with 100% accuracy and mail claims to insurance carriers daily.
• Enters documentation and adjustments through computer system to maintain a correct account balance.
• Updates system information daily according to correspondence received and processed.
• Documents any changes on a daily basis and submits information to appropriate personnel.
• Seeks clear directions to resolve issues and bring problems to a proper resolution.
• Reviews and identifies charge discrepancies and completes all requests for rebilling from inter-department personnel.
• Reviews charge summaries on each patient bill that is produced and identifies discrepancies with 100% accuracy.
• Audits requests for accurate information.
• Completes rebilling within 10 days according to established rebilling procedures.
• Manually documents rebilling log upon completion with 100% accuracy.
• Prepares daily production reports, maintains required records, reports, and files while evaluating account information.
• Makes sure number of accounts and outstanding balances within three days of receiving report.
• Consistently applies appropriate procedures to prevent accounts from becoming delinquent or remaining unbilled.
• Initiates appropriate follow-up.

SPECIFIC EXPERIENCE REQUIREMENTS

• Sufficient prior experience with billing, scheduling and general office responsibilities in a clinic setting.

SPECIFIC EDUCATIONAL REQUIREMENTS

• High School Diploma preferred, post high school vocational/specialized training encouraged.

SPECIAL SKILL, LICENSE AND KNOWLEDGE REQUIREMENTS

• Minimum typing skills of 45 wpm, ten key by touch, data entry skills.

HIPAA REQUIREMENTS

• Maintains knowledge of and adherence to all applicable HIPAA regulations appropriate to Job Position.

Safety Requirements

• Maintains knowledge of and adherence to all applicable safety practices appropriate to Job Position including but not limited to: incident reporting, handling wastes, sharps and linens, PPE, exposure control plan, hand washing, and environmental round to ensure safety.