Billing Specialist

Denise L. Krok, COE, CPSS, ST - Aiken, SC
Posted: August 26, 2019

This job description depicts many of the duties that are delegated to multiple billing office personnel on a daily basis.

DEPARTMENT:        Business Office

REPORTS TO:          Billing Supervisor

Job Summary:      These individuals are responsible for posting, billing, follow-up and collection of all charges, insurance claims; maintaining correspondence with carriers, and documentation regarding same; working accounts receivable to review problem accounts and identify necessary action to be taken. Any other duties as directed.

Education and Experience:

  • High school diploma or equivalent.
  • Two years minimum experience in medical office; billing and collections experience preferred.

Essential Skills and Abilities:

  • Excellent communication skills, written and oral.
  • Strong organization skills with attention to detail.
  • Excellent follow-up skills.
  • Management of multiple tasks simultaneously.
  • Ability to work as a team player.

RESPONSIBILITIES:

1.   Primary Responsibilities

  • Is responsible for full collection procedures on all patients.
  • Responsible for posting all payments and procedures / services for all entities as assigned
  • Data entry of Demographic and Insurance Information as needed
  • Complete and balance audit trail nightly.
  • Complete daily deposit slips for all entities as assigned.
  • Transmit insurance claims daily for all entities, send to secondary insurances as needed.
  • Review reports daily and correct denials, follow up with insurance companies as needed.
  • Scan all EOB’s in image Document
  • Processes and mails bills on a weekly basis.
  • Generates monthly A/R report for all accounts 60 days and over, for all pay classes.
  • Calls those accounts which are 60 days past due.
  • Establishes possible payment plans if appropriate and agreeable.
  • Maintains daily log of patients from whom the practice is expecting payment; follows-up on non-payments.
  • Works with supervisor to determine which accounts over 90 days need appropriate tracer letters.
  • Pulls copies of insurance claim forms each morning; checks each claim through the system to determine whether or not the claim has been paid; sends appropriate tracer letter for claims not paid.
  • Monitors the results of previous letters; sends stronger letters if no activity has resulted.
  • Meets with the Billing Supervisor daily to discuss problem accounts and plans for upcoming week.
  • Monitors daily appointment schedules to become aware of scheduled patients with open balances; put account notes in practice management and prints bill.
  • Takes calls directed to the accounts receivable department from patients and/or insurance carriers. Discusses accounts with patients and provides whatever information is required by insurance companies in order to get claim paid.
  • Reviews the accounts Aging Analysis Report monthly to determine the accounts requiring immediate attention (60 days and over $500 balance are priority). These accounts are to be entered onto worksheets and worked at once.
  • Back up check out as needed, schedules return appointments as necessary, explains all fees and patient financial responsibility.
  • Reviews fee sheets for correct charges and diagnosis marked; enter information into computer.
  • Maintains updated billing procedures and correct coding modifiers.
  • Verify that all testing that is charged for was performed.
  • Enter account notes as to when last refraction was done.

2.   Secondary Responsibilities

Assists receptionist with overflow of incoming calls.
Performs other duties, as required.
Cover front office positions as needed

 

 

 

 


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Denise L. Krok, COE, CPSS, ST

Denise L. Krok, COE, CPSS, ST

Aiken, SC

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