Phone Specialist I
6 days ago
Job Description
Job Title: Billing - Phone Specialist
Reports to: Customer Care Center Supervisor
Department: Billing Rental Rev Mgmt.
Job Summary:
The Billing - Phone Specialist will work with Inogen's 3rd party Billing partners, Medicare, Medicaid, Commercial Insurance companies, and customers to ensure medical claims are being processed timely and paid correctly. The Billing - Phone Specialist is responsible for managing all patient billing inquiries while demonstrating excellent customer service. Ensures all billing practices and processes follow all applicable compliance and regulatory processes, payor guidelines, and Inogen policies and procedures.
Responsibilities (Specific tasks, duties, essential functions of the job):
Billing - Phone Specialist I:
- Handles all patient billing inquiries, providing excellent customer service.
- Able to deescalate and resolve complex patient billing issues.
- Responsible for assisting our patients, doctors, customers, and coworkers with billing inquiries at the highest-level support possible, including logging into phone queue and updating statuses appropriately.
- Works with the patient to ensure Medicare, Medicaid, Commercial Insurance, and Private Pay claims are processed timely and paid accurately.
- Has a thorough knowledge of payor requirements for reimbursement; stays abreast of changes to reimbursement and coverage criteria for payor groups and markets.
- Demonstrates excellent customer service skills while engaging the physician, patient, and payor to obtain documentation required to resume billing or resolve denials.
- Displays a working knowledge of third-party payor procedures such as eligibility and verification, claims submission, reimbursement, and collection policies.
- Demonstrates knowledge for third-party payor groups including, but not limited to: Medicare, Medicaid, and other third-party contractual agreements entered into by Inogen.
- Performs reconciliations of data from two or more systems to ensure agreement and readiness for invoicing.
- Researches patient billing issues to determine the cause of the error and assists with claims resubmission when needed.
- Ensures all billing systems are updated timely with patient demographics, payer information, and notes.
- Uses appropriate write-off reason codes for uncollectable balances.
- Works with IT to develop, enhance, and monitor system integration and process flows.
- Works with 3rd party Billing Partner to ensure alignment of billing processes and Partner SOP.
- Ensures that medical records are maintained according to HIPAA guidelines.
- Ensures Inogen's compliance with all state and federal regulations.
- Assists with any other duties as assigned.
In addition to the responsibilities listed for Billing Phone Specialist I, a Billing Phone Specialist II (Senior) may also be responsible for the following:
- Assists junior team members with general work-related issues and/or questions about departmental processes.
- Assists with monitoring team production & quality to ensure KPI standards are met or exceeded.
- Identifies process improvement opportunities and recommends potential solutions to improve departmental workflow.
- Responsible for reporting & analysis of daily/weekly/monthly reporting of department activities.
- A comprehensive understanding of Medicare, Medicaid, and/or Commercial Insurance program rules as they pertain to DME billing.
- Ability to take direction and communicate effectively with customers and employees at all levels of the organization.
- Ability to thrive in a fast-paced and dynamically changing organization.
- Must have a strong work ethic.
- Excellent oral and written communication skills required.
- Attention to detail is required.
- Effective conflict resolution.
- Ability to maintain confidentiality and exercise extreme discretion.
- Solutions-oriented problem solver.
- Excellent planning, communication, and organizational skills.
- Operates at a task + project level for select projects which are specifically assigned.
- Some supervision required.
Billing Phone Specialist I:
- High School diploma or equivalent, required.
- Some College and/or medical billing certificate, preferred.
- 0-2 years of Medicare, Medicaid, and/or Commercial Insurance experience, required.
- 0-2 years' experience in oxygen or HME billing, preferred.
- Intermediate knowledge/proficiency in Microsoft Office, Oracle, Brightree, Salesforce, and New Voice Media, highly preferred.
- A combination of training, education, and experience that is equivalent to the qualifications listed above and provides the required knowledge, skills, and abilities.
- High School diploma or equivalent, required.
- Some College and/or medical billing certificate, preferred.
- 3-4 years of Medicare, Medicaid, and/or Commercial Insurance experience, required.
- 3-4 years' experience in oxygen or HME billing, preferred.
- Intermediate knowledge/proficiency in Microsoft Office, Oracle, Brightree, Salesforce, and New Voice Media, highly preferred.
- A combination of training, education, and experience that is equivalent to the qualifications listed above and provides the required knowledge, skills, and abilities.
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.
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