Infusion Billing Specialist

Oklahoma Arthritis Center (OAC) is an Equal Employment Opportunity employer and considers all applicants without regard to race, religion, color, sex, national origin, age, disability, veteran status, or any other legally protected status.

Job Summary: 

Reviews billing data from medical office records to ensure amounts and account numbers are accurate, responsible for account posting, collections, and verifying patient benefits.  Responsible for accurate diagnosis and procedure coding.  Responsible for insurance pre-certifications, pre-authorizations, pre-determinations and other required insurance notifications for procedures performed in the clinic.

 Essential Functions:

• Responsible for verifying and posting charges.
• Responsible for posting and monitoring payments from patients and third-party payers.
• Answers patient questions regarding their accounts and insurance coverage.
• Contacts insurance companies to verify medical insurance coverage for patient and to obtain information concerning extent of benefits.  Determine patient’s payment responsibility for procedures.
• Research and correct all insurance denials.
• Verify and obtaining required pre-certifications, pre-authorization, pre-determinations or other required notifications from third-party payers to insure payment.
• Identify delinquent accounts, aging period and payment sources.  Processes delinquent unpaid accounts by contacting patients and third-party payers.
• Perform various collection actions including contacting patients by telephone and/or letter and resubmitting claims to third-party payers.
• Evaluate patient financial status and establish payment plans.  Follow and report status of delinquent accounts.
• Review accounts for possible assignment to collection agency or other account determination.
• Oversee claim processing to include audits and review of claim payments for accuracy and compliance with contracts.
• Help patients with Patient Assistance programs.
• Responds to patient/payer inquiries in a timely manner
• Follows up on unpaid or improperly paid claims as necessary
• Reviews and monitors select accounts within the accounts receivable
• Ensure patient confidentiality and follow HIPAA guidelines.
• Promote a professional image by adhering to the established dress code as listed in Employee Handbook.
• Check and resolve assigned tasks in EMR program.

Performance Requirements:

Knowledge:

•  Knowledge of medical billing and collection practices.
•  Knowledge of basic medical coding.
•  Knowledge of third-party payer operating procedures and practices.
•  Knowledge of Medicare requirements.

Skills:

• Proficient skills in computer programs.
• Skill in trouble-shooting insurance claims and problems.
• Skill in establishing and maintaining effective internal and external working relationships.

Abilities:

• Ability to accurately enter data and examine insurance documents
• Ability to deal courteously with patients, staff and others.
• Ability to communicate effectively. 

Qualifications:

•  A High School Diploma or GED required.
•  A combination of six to twelve months of directly related training and/or billing experience in a health care organization is typically required for carrying out the responsibilities for this job.
• Experience with Microsoft Office Suite and Electronic Health Records/Practice Management, specifically Allscripts, preferred

Physical Requirements:

• Ability to work effectively in a fast paced environment.
• Physical ability to sit, perform data entry and view computer screen for long periods at a time.
  
• Occasional exposure to communicable diseases and biohazards.
• Daily standing, walking, bending, and maneuvering.
• May require lifting up to 50 pounds or more to transfer and/or turn patient with and without assistive devices.

Travel Requirements:

Travel may be required.

Scheduled Working Hours:

Normal work hours are 8:00 a.m. to 5:00 p.m., Monday through Thursday and 8:00 a.m. to 1:00 p.m. on Fridays. Hours may vary depending upon the needs of the position, department, and clinic.

Other Duties:

Please note this job description is not designed to cover or to contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change from time to time, with or without notice.

Equipment Operated:

Standard office equipment including: computers, printers, faxes, copiers, postage machine, etc.