Billing Specialist

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Full Time Clerical Mt Sterling, KY, US

Sterling Health Solutions, Inc.

Supervisor(s):
Director of Revenue Cycle

Department:
Finance

FLSA Status:
Non-Exempt

Effective Date:
August 18, 2015

Responsible for all facets of medical, vision and/or dental billing and accounts receivable management including charge entry, payment posting, customer service and follow-up in accordance with practice protocol with an emphasis on maximizing patient satisfaction and profitability. Responsible for reviewing the patient demographic information in the practice management system at the time of charge entry to ensure accuracy and to provide feedback to the other front office staff regarding patient registration.

Responsible for reviewing the physician’s coding at the time of charge entry to ensure accuracy, timely payments, and to maximize revenue. Responsible for submitting insurance claims as required by standard operating procedures. Responsible for providing cross coverage for the Authorization Coordinator, Receptionists as required to ensure efficient and professional practice operations and maximum patient satisfaction.

Follow-up on all outstanding insurance claims at 60
-days from the date of service in accordance with practice protocol with an emphasis on maximizing patient satisfaction and practice profitability.

Follow-up on all outstanding patient account balances at 90
-days from the date of service in accordance with practice protocol with an emphasis on maximizing patient satisfaction and practice profitability using the A/R aged reports.

• Input all charges into the practice management system including office charges in accordance with practice protocol with an emphasis on accuracy to ensure timely reimbursement and maximum patient satisfaction. All charge batches should balance in both number of procedures and total dollar prior to posting.
• Post all credit and debit adjustments to patient accounts with strict adherence to the guidelines in the Procedure Manual.
• File all charge, payment and adjustment batches in the appropriate format by batch date for quick reference.
• Review the providers coding at charge entry to ensure compliance with Medicare guidelines and to ensure accurate and timely reimbursement.
• Provide customer service both on the telephone and in the office for all patients and authorized representatives regarding patient accounts in accordance with practice protocol. Patient calls regarding accounts receivable should be returned within 1 business day to ensure maximum patient satisfaction.
• Verify all demographic and insurance information in patient registration of the practice management system at the time of charge entry to ensure accuracy, provide feedback to other front office staff members and to ensure timely reimbursement.
• Follow-up on all outstanding insurance claims at 60
  -days from the date of service in accordance with practice protocol with an emphasis on maximizing patient satisfaction and practice profitability.
• Follow-up on all outstanding patient account balances at 90
  -days from the date of service in accordance with practice protocol with an emphasis on maximizing patient satisfaction and practice profitability using the A/R aged reports.
• Provide information pertaining to billing, coding, managed care networks, insurance carriers and reimbursement to physicians, managers and subordinates.
• Follow-up on all returned claims, correspondence, denials, account reconciliations and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner with an emphasis on patient satisfaction.
• Submit primary and secondary insurance claims electronically each day and on HCFA semi-weekly to ensure timely reimbursement.
• Recommend accounts for outside collection when internal collection efforts fail in accordance with practice protocol.
• Process refunds to insurance companies and patients in accordance with practice protocol.
• Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates.
• Proficiency with all facets of the medical, dental or vision practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.
• Verify all…