Insurance and Billing Specialist

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Job description

Description:

This position supports practice revenue goals by monitoring patient accounts, taking remedial and preventive action to reduce rejected claims.

1. Facilitates timely collection of Accounts Receivable (A/R) by utilizing specialized knowledge, interacting with providers and co-workers to ensure all relevant information is obtained; determines primary and secondary carriers when necessary; reviews claims for accuracy and completeness before filing, monitoring insurance claims and contacting insurance companies to resolve claims that are not paid in a timely manner.

2. Researches cause(s) for denied claims, communicating with patient to obtain missing/correct information required for refiling; correcting any errors; verifying accuracy and completeness of corrected claims, refiling in a timely manner.

3. Supports the maintenance of complete and precise practice records by posting insurance payments promptly and accurately; entering clear notes into patient records explaining any changes made to account(s), etc.

4. Follows practice protocols to obtain additional information from patients/payers with past due accounts; identifies and escalates problem accounts as appropriate.

5. Works ques's and A/R reports to ensure prompt payment in both the Allscripts and Phreesia systems while working down old A/R.

6. Maintains productive relationship with third party payers and managed care organization by approaching payers' representatives in a positive and courteous manner; promptly corrects any errors (including misapplied payments and overpayments), etc.

7. Supports co-workers and practice revenue maximization efforts.

8. Supports the attainment of patient satisfaction goals by explaining insurance policy requirements, benefits and filing rules to patients; answers patient questions regarding account status, charges, co-pays, deductibles, non-covered services, etc. ; resolves patient billing complaints.

Requirements:

High School Diploma or equivalent and/or Relevant Associates Degree preferred. Knowledge of coding (CPT, ICD-9, HCPCS, etc.

Computer literacy especially practice PMS. Good customer service skills including both written and verbal. Must be able to ask for money and payments.

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