Phone Specialist I

Medical Billing Plano, Texas


Description

Job Summary:

Billing – Phone Specialist will work with Inogen’s 3rd party Billing partners, Medicare, Medicaid, Commercial Insurance companies, and customers to ensure medical claims are being processed timely and paid correctly. The Billing – Phone Specialist is responsible for managing all patient billing inquires while demonstrating excellent customer service. Ensures all billing practices and processfollow all applicable compliance and regulatory processes, payor guidelines, and Inogen policies and procedures.

Responsibilities(Specific tasks, duties, essential functions of the job)

Billing – Phone Specialist I

  • Handles all patient billing inquires, providing excellent customer service.
  • Able to deescalate and resolve complex patient billing issues.
  • Responsible for assisting our patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible. This includes logging into phone queue and updating statuses appropriately.
  • Works with the patient to ensure Medicare, Medicaid, Commercial Insurance, and Private Pay to ensure claims are being processed timely and paid accurately.
  • Has a thorough knowledge of payor requirements for reimbursement; stays abreast of changes to reimbursement and coverage criteria for payor groups and markets
  • Demonstrations excellent customer service skills while engaging the physician, patient, and payor to obtain documentation required to resume billing or resolve denials
  • Displays a working knowledge of third-party payor procedures such as eligibility and verification, claims submission, reimbursement, as well as an understanding of collection policies.
  • Demonstrates this knowledge for third party payor groups including, but not limited to: Medicare, Medicaid, and all other third-party contractual agreements entered into by Inogen.
  • Perform reconciliations of data from two or more systems to ensure everything is in agreement and ready for invoicing.
  • Research patient billing issues to determine the possible cause of the error and assist with claims resubmission when needed to correct the issue.
  • Ensures all billing systems are updated timely with patient demographics, payer information, and notated appropriately.
  • Uses appropriate write off reason code(s) for writing off balances that are deemed uncollectable.
  • Works with IT to develop, enhance and monitor system integration and process flows
  • Works with 3rdparty Billing Partner to ensure alignment of billing processes and Partner SOP
  • Ensures that appropriate medical records are maintained according to HIPPA guidelines.
  • Ensures Inogen's compliance with all state and federal regulations.
  • Assist with any other duties as assigned.

Billing Phone Specialist II

In addition to items listed for Billing Phone Specialist I, a Billing Phone Specialist II (Senior) may also be responsible for the following:

  • Assists junior team members with general work-related issues and/or questions about departmental processes.
  • Assist with monitoring team production & quality is meeting/exceeding KPI.
  • Able to Identify process improvement opportunities and recommend potential solutions to improve departmental workflow.
  • Responsible for reporting & analysis of daily/weekly/monthly reporting of department.

Knowledge, Skills, and Abilities

  • A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as it pertains to DME billing.
  • Ability to take direction and communicate effectively with customers and employees at all levels of organization.
  • Ability to thrive in a fast-paced and dynamically changing organization.
  • Must have strong work ethic.
  • Excellent oral and written communication skills required.
  • Attention to detail is required.
  • Effective conflict resolution.
  • Ability to maintain confidentiality and exercise extreme discretion.
  • Solutions-oriented problem solver.
  • Excellent planning, communication and organizational skills.
  • Operates at a task + project level for select projects which are specifically assigned
  • Some supervision required.

Qualifications(Experience and Education)

Billing Phone Specialist II (Senior)

  • High School diploma or equivalent, required.
  • Some College and/or medical billing certificate, preferred
  • 3-4 years of Medicare, Medicaid and/or Commercial Insurance experience, required.
  • 3-4 years' experience inoxygen or HME billing, preferred.
  • Intermediate knowledge/proficiency in Microsoft Office, Oracle, Brightree, Salesforce and New Voice Media, highly preferred. 
  • A combination of training, education and experience that is equivalent to the qualifications listed above and that provides the required knowledge, skills, and abilities.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified.