Medical Billing and Collections Specialist
2 weeks ago
Job Overview:
OBJECTIVE:
The role of the Medical Billing and Collections Specialist is to ensure the accurate invoicing, reconciliation, and collection of payments for complex accounts, thereby maintaining the integrity of the core system and ensuring client satisfaction.
This position serves as the primary contact for both internal and external stakeholders regarding intricate billing and collection matters.
The specialist will contribute to the enhancement of processes and address inquiries, ensuring that all payments related to services are recorded and reconciled promptly to optimize revenue streams.
The incumbent may also support upper management projects by providing analytical and reporting assistance for purposes such as:operational efficiency assessments, quality metrics, productivity analysis, end-of-month accounts receivable reconciliation, and monthly aging reports.
KEY RESPONSIBILITIES:
25% Investigates and addresses complex patient inquiries related to billing through various communication channels.
25% Evaluates billing documentation for accuracy and completeness prior to submission to payors.
20% Aids in the generation of monthly billing and accounts receivable reports.
15% Assists with intricate billing challenges, including liaising with insurance providers to verify patient eligibility and referral details.
10% Ensures the collection of all necessary insurance, demographic, and eligibility data from patients, entering it into the system accurately and promptly.
5% Complies with HIPAA regulations and other pertinent state and federal guidelines, as well as company policies regarding compliance, integrity, patient privacy, and ethical billing practices.
Qualifications:
To excel in this role, candidates must demonstrate the ability to perform each essential duty effectively. The qualifications listed below reflect the knowledge, skills, and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to fulfill the essential functions.
Educational Background:
High School Diploma or GED
Experience: Minimum of 3 years in a Billing, membership enrollment, member services, claims operations, or Finance role.
Preferred Skills:
Knowledge, Skills, and Abilities (KSAs):
Proficient in Microsoft Office applications, Advanced
Exceptional customer service skills with a focus on departmental objectives, Advanced
Ability to thrive in a deadline-driven environment; results-oriented, Advanced
The incumbent must promptly disclose any debarment, exclusion, or other circumstances that render them ineligible to work directly or indirectly on Federal health care programs.
Must effectively navigate a fast-paced environment with frequently shifting priorities, deadlines, and workloads that may vary significantly over extended periods.
Must consistently meet established deadlines and manage multiple customer service requests from both internal and external clients, adhering to expectations for service excellence.
Must possess strong communication skills and provide exemplary customer service to all internal and external clients, including those who may present challenges.
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