Medical Billing Specialist

Medical Billing Specialist

A nonexempt position responsible for processing patient and insurance payments with accurate provider discounts, accurate data entry of charges payments, submission of all insurance claims. Maintain daily files. Answer and resolve billing office inquires in a prompt, courteous and professional manner.

Essential Duties and Responsibilities:

• Open and separate daily mail.
• Balance and post patient payments, prepare them for bank deposit.
• Balance and post all insurance payments, prepare them for bank deposit.
• Process, post, and balance all credit card payments.
• Review insurance explanation of benefits, determine appropriate provider discount, review claim rejects, post to patient accounts.
• Prepare bank deposit and maintain daily deposit log.
• Resubmit claims that require additional information, refer claim rejects that require coding and high provider discounts to office manager.
• Request and submit any secondary or third insurance claims with appropriate coordination of benefit information.
• Print and monitor electronic insurance claim submission reports. Correct and resubmit any rejections.
• Print appropriate paper claims and sent to insurance company with any needed attachments.
• Respond to requests from insurance companies for additional information.
• Research and prepare patient and insurance company refunds. Post, balance, and cut refund checks.
• Answer and resolve billing office phone inquiries.
• Post, balance, and maintain daily work files (payments, adjustments, charges, refunds).
• Performs other various business office duties as assigned.

Education and/or Experience Required:

• High school diploma or equivalent. Some college preferred.
• Minimum two years of medical billing office experience.
• Retina experience required.

Certificates, Licenses and/or Registrations Required:

• None.

Performance Requirements:

Knowledge:

• Knowledge of medical billing/collection practices.
• Knowledge of basic medical coding and third-party operating procedures and practices.
• Knowledge of legal and regulatory government provisions.

Skills:

• Skill in establishing and maintaining effective internal and external working relationships.

Abilities:

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

Equipment Operated: Standard office equipment including computers, scanner, fax machines, copiers, printers, telephones, etc.

Work Environment: Position is in a well-lighted office environment. Occasional evening and weekend work.

Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.