This position is responsible for insurance account receivables. This position is also responsible for following-up, documentation, working with supervisor to review problem accounts and identifying necessary action to be taken by performing the following duties. Critical thinking is essential to success in this position.
ESSENTIAL DUTIES AND RESPONSIBILITIES:
Core duties and responsibilities include the following. Other duties may be assigned.
- Is familiar with insurance company process and ability to read and understand explanation of benefits (EOB) to verify insurance or patient responsibility for claim.
- Follow all regulations and guidelines set by Medicare, state programs, and HMO/PPO.
- Preparing, reviewing, and transmitting claims using billing software, including electronic and paper claim processing.
- Following up on unpaid claims within standard billing cycle timeframe.
- Checking each insurance payment for accuracy and compliance with contract discount.
- Calling insurance companies regarding any discrepancy in payments if necessary.
- Identifying and billing secondary or tertiary insurances.
- Researching and appealing denied claims.
- Researching and posting insurance retractions to accounts.
- Use Carrier web portals to verify coverage and benefits.
- Updating cash spreadsheets and running A/R reports.
- Follow set billing processes and procedures.
- Work with personal information and maintain patient confidentiality.
- Serve as back-up for charge entries.
- Updates job knowledge by participating in educational opportunities.
- 3+ years of Medical Billing experience
- Ability to work independently
- Competent use of computer systems, software, and 10 key calculators.
- Microsoft Excel experience
- Familiarity with CPT and ICD-10 Coding.
- Effective communication abilities for phone contacts with insurance payers to resolve issues.
- Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.
- Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.
- Knowledge of medical terminology likely to be encountered in medical claims.
While we appreciate everyone's interest in working at Retina Institute of Virginia, you must have experience to be considered for this position. EOE.