Medical Billing Services Specialist

Role Overview

• Receive incoming calls from customers regarding patient accounts not limited to statements, billing, claims, denials, and all other reimbursement matters
• Investigate escalated customer billing inquiries and take appropriate action to resolve the account
• Research, resolves, corrects, and prevents invoice discrepancies by active interaction with customers and other appropriate staff/departments
• Routes pending insurance and claims processing matters to appropriate staff for follow up
• Communicate medical insurance coverage benefits (in network / out of network) including out of pocket responsibilities, deductible, and coinsurance
• Answer questions regarding the processing of medical claims including denials by insurance companies for products provided
• Resolve customers' billing complaints by performing activities in the billing cycle not limited to resolving hold accounts, granting adjustments (write-offs), and small balance reviews
• Prepares and sends correspondence to customers related to invoices and payment history when requested
• Collaborates with internal staff to resolve account hold due to bad debt
• Locate and notify customers of delinquent accounts by mail, telephone, or personal visits to solicit payment
• Complete private pay charges for balances owed via checks and credit card payments
• Arrange for debt repayment or establish repayment schedules, based on customers' financial situations
• Performs detailed account reconciliations as needed to resolve complex disputed receivable issues
• Collect on accounts by sending bills or following up on bills with payers via phone, email, fax, mail, or websites
• Utilizes collection techniques to resolve accounts according to company’s policies and procedures
• Ensure organization receives accurate payment for goods provided according to contracted rates and/or payer fee schedules
• Respond to Collection agency regarding patient disputes of balances owed on accounts
• Reconcile the accounts receivable to ensure that all payments are accounted for and properly posted
• Monitors system dashboard related to patient collections
• Creates daily reports from the system for patient collection activity
• Responsible for entering data in an accurate manner, into database including although not limited to payer, authorization requirements and coverage limitations
• Responsible for the daily claims submissions/printing for all eligible/ready status claims
• Monitor patient account details for non-payments, delayed payments, and other irregularities
• Analyze documentation required for billing services and ensure compliance to payer requirements
• Resolve pending revenue by reconciling received documentation and pending charges
• Performs extensive account audits and ensures proper billing for services to the accurate payer
• Ensures proper revenue recognition for billed charges and services moving forward

Requirements

• High School Diploma or G.E.D.
• 1 year of related experience in healthcare administration, financial or insurance customer service, claims, billing, or call center
• 2 + years of credit/collection experience in DME preferred
• Excellent decision-making abilities
• Analytical and problem-solving skills with attention to detail
• Strong verbal and written communication
• Excellent customer service skills
• Ability to prioritize and manage multiple tasks
• Knowledge of medical terminology used in medical billing, current office practices and procedures, and basic math
• Knowledge of methods for qualifying for funding; collection laws, regulations, and techniques

Benefits

• Flexible work schedules with summer hours
• Market-aligned pay
• 401k dollar-for-dollar matching up to 6% with immediate vesting
• Comprehensive benefit plan offers
• Flexible Spending Account (FSA)
• Health Savings Account (HSA) with employer contributions
• Life Insurance, Short-term and Long-term Disability
• Paid Paternity Leave
• Employee Assistance Program
• Wellness Resources
• Training and Development
• Tuition Reimbursement