Description

POSITION SUMMARY:

This position is responsible for the financial activities of patient accounts to include but not limited to all of the following: cashiering, bank deposits and reconciliation, refunds, posting of cash and adjustments, scanning, and coordinating with the DHR billing department to work on AR including denials and appeals.  Perform and oversee insurance authorization and verification processes.  Communicate timely and effectively with front office staff regarding authorization requirements and status.  Provides excellent customer service to patients regarding any billing inquiries and provides explanation for any inquiries.

POSITION EDUCATION/ QUALIFICATIONS­:

• High School/GED required
• Medical Office Specialist certificate, preferred
• Excellent customer service skills
• Computer skills required with knowledge of Microsoft Office suite, Internet
• EMR experience preferred
• Good written and verbal communication skills required
• Excellent customer service skills
• Bilingual – English/Spanish – required

JOB KNOWLEDGE/EXPERIENCE­:

• Two (2) years’ experience in a physician or hospital business office required
• Experience working with Excel spreadsheet is required

POSITION RESPONSIBILITES:

• Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practice
• Prepares office visit, office procedures, hospital procedures, and ancillary procedures and enters into the computer system and reconciles to the system report or scans the charges to the billing vendor as needed
• Posts live commercial, co-pay and other payments as received daily
• Prepares deposit for Office Manager's review and daily deposit
• Works all correspondence received, including zero payments, denials and other information received from the DHR billing department/ ins. carriers on a daily basis to assist with work administrator duties
• Receives calls/visits from patients and assists staff with questions regarding payments, EOB’s and reasons for denials as requested
• Helps to answer phones with any customer service questions from the public or ins. carriers as needed
• Uses TMHP portal to review patients who are pending Medicaid numbers in order to add those numbers to billings for hospital procedures in order to bill in a timely manner
• Verifies insurance for any visit/procedure as needed, including pre certification and pre authorizations
• Sends day end report to billing vendor, ensuring that all daily tasks are complete and ready for review
• Meet with patients who have balances and need to make payment arrangements, as needed
• Helps with any customer service questions relating to billing or balances owed as needed in coordination with the DHR billing department.
• Take messages from the voice mail, returning calls, and helping patients, as needed
• Timely completion of daily, weekly and monthly reports
• Auditing of office visit and procedure charges
• Goes to the bank and/or post office as needed
• Cross trained to all areas of the front office
• Ensures that charge reconciliation is performed daily.
• Other duties as assigned.

LINES OF REPSONSIBILITES:

(Chain-of-command)

Billing Specialist →     2. Lead Billing Specialist         →        3. Administrator