Medical Office Associate/Billing Specialist

SCOPE OF RESPONSIBILITIES

Medical Office Associate and Billing Specialist
PRECISE seeks an experienced Medical Billing Specialist to join their team. Responsibilities include:
A. Billing

1.  Processes insurance claims with individual carriers or agencies to maximize reimbursement.
2.  Processes appeals to insurance companies.
3. \ Prepares, reviews and sends patient statements.
4.  Contacts patients by telephone and resubmits claims to third party reimburses.
5.  Responds to written, electronic and telephone inquiries from patients and insurance companies regarding patient accounts.
6.  Identifies and resolves patient billing complaints.
7. Refunds patient payments when necessary.

B. Posts insurance payments, returned checks, fees, and patient payments to patient accounts.
 

C. Office routines

1.  Reviews each account via computer, reports, and payment sources.
2.  Identifies delinquent accounts, aging period, pay sources and reports status of delinquent accounts.
3.  Notifies physician of outstanding accounts prior to scheduling patient.
4.  Makes recommendations to supervisor and prepares information for collection agency.
5.  Contacts patient by telephone, or meets with patient in clinic, evaluates patient financial status and establishes budget payment plans.
6.  Receives and records credit card and other payments by telephone.

D. Precertification

1.  Verifies insurance coverage and benefits.
2. Contacts patient, confirms coverage, and informs patient of their cost.
3. Completes pre-registration form for patients having procedures in the Endoscopy Center.
4.  Forwards pre-registration form to check-in at Endoscopy Center through EMR.

E. Special Projects

1.  Performs other related work as required.
2. Participates in studies, research projects, or company projects as directed.

Incumbent performs other job-related tasks as assigned and required; any duties/tasks included in the employee's performance evaluation are essential to that employee's position within the job classification.
Computer Skills: Working Knowledge of Microsoft Office (Word, Excel,); computer skills sufficient to enter and retrieve data from an Electronic Medical Records system.
 

Competencies: The following competencies describe additional knowledges, skills, abilities, and attributes that lead to a successful employee in this position. Employees in this position may be evaluated on these competencies as part of the performance appraisal system.

1. Maintains strictest confidentiality.
2. Treats people with respect and consideration, regardless of their status or position, honoring cultural differences and promoting harassment –free environment.
3. Uses oral and written communication skills to effectively convey ideas in a clear, positive manner.
4. Maintains and follows established PRECISE policies, procedures, and objectives.
5. Observes quality assurance, environmental, safety and security procedures.
6. Conserves organizational resources and is mindful of financial stewardship.
7. Cooperates with medical and administrative staff to ensure compliance with standards and regulations.
8. Responds promptly to customer service needs and requests for service or assistance.
9. Identifies and resolves problems in a timely and professional manner.
10. Adapts to changes in the work environment and manages competing demands.
11. Exhibits sound and accurate judgment and makes timely decisions appropriate to job classification.
12. Implements job responsibilities in a manner that is consistent with GIA's Mission and Code of Ethics.

WORK ENVIRONMENT: The noise level in the work environment is usually moderate. Work is performed in an office environment. Frequent contact with insurance companies and staff with other providers. Patient contact may involve dealing with angry or upset people. Operates keyboard, photocopier, telephone, calculator and other office equipment. Requires occasional evening or weekend work.

EDUCATION/EXPERIENCE REQUIREMENTS

Potential employee should possess the following:

1. High School Graduate with college coursework preferred.

2. Two years’ experience and working knowledge in medical billing functions of third party payer systems including Medicare and commercial insurance is preferred.

3. Two years’ experience working in a physicians’ office is preferred with the proven ability in the areas of:

   1. Multi-tasking

   2. Flexibility

   3. Telephone Skills

   4. Customer Service

   5. Time Management

   6. Organization

   7. Attention to Detail

   8. Scheduling

   9. Professionalism

   10. Quality

4. Previous experience in operation of office machinery including a copier, fax, computer and printer.

5. Proficiency in Microsoft products including excel, word and outlook

6. Valid certification in billing and coding OR two years verified experience in medical billing