Business Office Specialist

A nonexempt position responsible for processing patient and insurance payments with accurate providerdiscounts, accurate data entry of charges payments, submission of all insurance claims. Maintain dailyfiles. Answer and resolve billing office inquires in a prompt, courteous and professional manner.

Department: Administration

Job

Supervisory Responsibilities:

None

• Open and separate daily mail.
• Balance and post patient payments, prepare them for bank deposit.
• Balance and post all insurance payments, prepare them for bank deposit.
• Process, post, and balance all credit card payments.
• Review insurance explanation of benefits, determine appropriate provider discount, review claim rejects,post to patient accounts.
• Prepare bank deposit and maintain daily deposit log.
• Resubmit claims that require additional information, refer claim rejects that require coding and highprovider discounts to office manager.
• Request and submit any secondary or third insurance claims with appropriate coordination of benefit information.
• Print and monitor electronic insurance claim submission reports. Correct and resubmit any rejections.
• Print appropriate paper claims and sent to insurance company with any needed attachments.
• Respond to requests from insurance companies for additional information.
• Research and prepare patient and insurance company refunds. Post, balance, and cut refund checks.
• Answer and resolve billing office phone inquiries.
• Post, balance, and maintain daily work files (payments, adjustments, charges, refunds).
• Performs other various business office duties as assigned.

• High school diploma or equivalent. Some college preferred.
• Minimum two years of medical billing office experience.

• None.

• Knowledge of medical billing/collection practices.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Knowledge of legal and regulatory government provisions.

• Skill in establishing and maintaining effective internal and external working relationships.

• Ability to enter accurately data and examine insurance documents.
• Ability to deal courteously with patients, staff, and others.
• Ability to communicate effectively and clearly.

Equipment Operated: Standard office equipment including computers, scanner, fax machines,copiers, printers, telephones, etc.

Work Environment: Position is in a well-lighted office environment. Occasional evening and weekend work.

Mental/

Physical Requirements:

Involves sitting approximately 90 percent of the day, walkingor standing the remainder.

St. Paul Eye Clinic is an equal employment opportunity/affirmative action employer and complies with all applicable laws relating to discrimination against qualified applicants or employees in hiring or in anydecision affecting job status,pay, or any other terms and conditions of employment based on race, color, creed, religion, national origin, sex, marital status, familial status, disability, genetic information, sexual orientation, age,or other applicable protected classes.