Responsible for collecting, posting account payments. Responsible for submitting claims and following up with insurance companies, assist the Controller and CFO in the day to day operations of the Billing Department.
Provide leadership, direction, assist the controller and CFO in the position’s duties with utmost customer care, compassion, and integrity in supporting the quality of care for the patients and the community.
Full-time, goal-oriented, revenue-driven, highly accurate and motivated biller and leader who will establish and maintain strong relationships with providers, clients, patients and fellow staff.
Excellent and competitive benefits package offered which includes medical, dental, vision, disability and life insurance. Company matching retirement plan and generous paid time off to include vacation and sick leave accruals starting from the date of hire.
- Ensure all billing activities are consistent with protocols and in compliance with government and payer regulations
- Serve as the practice expert for all coding and billing functions/processes. Bill secondary insurance carriers.
- Process electronic and paper medical and dental claims submission daily, review for errors and completeness and make necessary corrections. Ensure electronic claims are received by Clearinghouse (ClaimsRemedi).
- When additional information is necessary for complete and accurate billing, work with the center staff to ensure all patient information is complete and accurate.
- Prepare and bill “special contract” (Catholic Charities), invoices according to contract terms (if necessary.)
- Post all non-payment EOBs for deductibles and apply to any SFS. Ensure all $0 EOBs received in the month are posted prior to month end close. Lead the team in investigating denials on EOBs, request information needed to reprocess claims, make necessary corrections, and resubmit claim. Document reason and date of re-bill in applicable Notes.
- Review insurance company correspondence, acquire information to respond to insurance companies request, and reply or re-bill when possible. If determined to be Patients responsibility – note on the correspondence, and forward to Collector, (i.e., Patient has failed to forward requests for information to the insurance company.) If patient is not covered under policy, and there is no other coverage, re-class to pay patient and apply SFS. Document in “Notes” section in PM system.
- Work A/R and follow-up on outstanding third-party on a monthly basis for special programs sixty (60) days and over by working insurance pending reports and month end aged A/R by payer listing. This includes phone calls and/or written correspondence. Document collection activities in the “Notes” section in the system (payer codes 60 and higher).
- Assist with monthly report for controller and CFO for timeliness of responses to requests for information and examples of input errors that cause the claim to be rejected/re-billed/reprinted and electronic billing errors.
- Prepare bad debt report on monthly basis for board approval and write off.
- Assist the controller and CFO with assigning work schedules to the billing staff and ensuring the billing staff understand their job duties and are carrying them out.
- Ability to recognize and respect cultural diversity of patients.
- Ability to assist the controller and CFO in the credentialing process of Providers.
- Recognize and respond effectively to verbal, nonverbal, and written communication.
- Ability to follow established policies and procedures dealing with health care.
- Must respect the confidential nature of medical information.
- Working knowledge of standard concepts, practices, and procedures.
- Professional manner and appearance.
- Good telephone etiquette and organizational skills
- Capable of using good judgement to plan and accomplish goals.
- Associates degree in Accounting/Finance.
- 1 year experience in medical insurance claims processing.
- 1 year of experience in NextGen.
- 3 – 5 years of supervisory experience.
- 1 – 2 years of accounts receivable experience
Skills and Abilities
- Good telephone etiquette and organizational skills.
- Able to handle diversified duties.
- Must be computer literate and have the aptitude to learn new programs as changes occur.
- Strong organization and supervisor skills.
- Solid attention to detail to ensure accuracy of information.
- Ability to present and communicate effectively.
Typical Physical Demands
The physical demands described herein are representative of those that must be met by a staff member to successfully perform the essential functions associated with this position. Because we are committed to inclusion of those with disabilities, reasonable accommodations will be made to enable individuals with disabilities to perform the essential functions associated with their position.
- Carrying: Transporting an object, usually by hand, arm or shoulder.
- Lifting: Raising or lowering an object 25-50 pounds.
- Repetitive Motions: Making frequent movements with a part of the body.
- Sedentary work: Exerting up to 10 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time. Jobs are sedentary if walking and standing are required only occasionally and all other sedentary criteria are met.
- Talking: Expressing or exchanging ideas by means of the spoken word; those activities where detailed or important spoken instructions must be conveyed to other workers accurately, loudly, or quickly.