Medical Billing Specialist - Front End

JOB DESCRIPTION Business Title: Medical Billing Specialist Team/Location: Billing Practice Suite/Remote Reports To: Medical Billing Lead FLSA Status: Non-exempt POSITION SUMMARY: The Medical Billing Specialist performs complex clerical and accounting functions for patient billing, including verification of invoice information, maintenance of third-party billing records, and resolution of problems. Follows up on submitted claims and patient billing; resubmits claims or correct inaccuracies. May handle accounts receivable postings. Works with others in a team environment. ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Processes billing to patients and third-party insurance companies.
• Maintains supporting documentation files and current patient addresses.
• Researches and responds by telephone and / or in writing to patient inquiries regarding billing issues and problems.
• Monitors submitted claims; follows up on unpaid claims, and initiates dialogue with insurance companies.
• Resubmits claims to insurance companies as necessary.
• May receive and receipt cash items and third-party reimbursements.
• Posts and reconciles payments to patient ledgers.
• Balances daily batches and reports.
• Maintains patient demographic information and data collection systems.
• Participates in development of organization procedures and update of forms and manuals.
• Performs a variety of general clerical duties, including telephone reception, mail distribution, and other routine functions.
• Answers questions from patients, clerical staff and insurance companies.
• Identifies and resolves patient billing complaints.
• Evaluates patient’s financial status and establishes budget payment plans.
• Follows and reports status of delinquent accounts.
• Reviews accounts for possible assignment to collections and makes recommendations to the Billing Team Leader also prepares information for the collection agency.
• Performs various collection actions including contacting patients by phone, correcting and resubmitting claims to third party payers.
• Works in conjunction with the reception to ensure clean billing.
• Performs miscellaneous job-related duties as assigned.
• Participates in educational activities and attends monthly staff meetings.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Assists in development and communication of SOP for key areas to improve accuracy and understanding of processes.

KNOWLEDGE OF: Modern office practices, procedures and equipment. Correct English usage, grammar, spelling, punctuation and vocabulary. Oral and written communication skills, finance and legislation. PPM organization, operation, policies and objectives Interpersonal skills using tact, patience and courtesy Intermediate personal computer operation, including word processing, spreadsheets, and database management Basic research methods ABILITY TO: Communicate effectively both orally and in writing. Demonstrate proficiency in MS Suite Establish and maintain cooperative and effective working relations with others. Learn, apply and explain policies, procedures, rules, and regulations. Analyze situations accurately and determine an effective course of action. Plan and organize work. Work confidentially with discretion. Do mathematical calculations Use personal computer with intermediate software and other normal office equipment. Maintain accurate records and files. SUPERVISION EXERCISED: None. EDUCATION and/or EXPERIENCE High School diploma or higher plus 2 years of office experience. Or an equivalent combination of education and experience. CPC certification through AAPC WORK ENVIRONMENT The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. PHYSICAL DEMANDS While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel; and talk and/or hear. The employee frequently is required to walk and sit. The employee is occasionally required to stand and reach with hands and arms. The employee must occasionally lift and/or move up to 10 pounds. Specific vision abilities required by this job include close vision. GENERAL SIGN OFF: All employees have a responsibility to comply with our organization’s policies and procedures, adhere to our Code of Conduct, complete required compliance training modules, and report any observations of non-compliance. I have read and understand this job description and recognize it may change to meet the needs of the business. Employee's signature: _____________________________ Date: _________________ Supervisor’s signature: ____________________________ Date: _________________ Job Type: Full-time Pay: From $20.00 per hour Benefits:

• Flexible schedule

Experience:

• 3rd Party Billing (RCM): 1 year (Preferred)
• Insurance Investigation: 1 year (Preferred)
• Clearinghouse/Payer Rejections: 1 year (Preferred)

License/Certification:

• CPC certification through AAPC (Preferred)

Work Location: Remote Apply tot his job Apply To this Job