Billing Collection Specialist Fitness and Rehab

Mount Nittany Health•State College, PA

17h•Onsite

About The Position

POSITION SUMMARY The position bills claims to HMO’s, Blue Cross Plans, Medical Assistance, and Medicare. Reviews registrations for complete information obtained by registration to insure accurate billing. Performs a variety of duties relating to interfacing with insurance professionals. Performs duties relating to the processing of data for billing purposes. The Primary Billing/ Collections Specialist will actively participate as a member of the healthcare team to engage patients, families, and caregivers in the coordination of patient care. MINIMUM REQUIREMENTS Education: High School graduate or equivalent. Graduate of an approved medical secretarial Associate Degree program preferred. Experience: Relevant experience in a related position which has provided the applicant with strong working knowledge in HIPPA compliance coding and billing. Knowledge, Skills, Abilities: Demonstrating knowledge in HIPPA compliant ICD-9 CM Diagnosis and procedure codes, CPT-4 codes, billing HIPPA compliant claims electronically on standard hospital forms or (alternatively). Must have working knowledge and proficiency in computer operation. This individual must be able to work as a team member with job sharing. Ability to speak clearly and communicate effectively in a pleasant tone to staff and insurance professionals regarding charges, coding and diagnosis problems is essential. Possess thorough knowledge of claims submission process. Must have knowledge of the assigned third parties' billing requirements. Must display professional mannerism and appearance. License/Certification/Registration: None WORKING CONDITIONS Normal office environment. May require working various shifts to ensure adequate coverage. PHYSICAL DEMANDS Requires manual and finger dexterity and hand-eye coordination. May require long periods of sitting while working at a computer terminal. May also require lifting, stooping, reaching and bending to retrieve files and supplies. Requires corrected vision and hearing to normal range.

Requirements

High School graduate or equivalent.
Relevant experience in a related position which has provided the applicant with strong working knowledge in HIPPA compliance coding and billing.
Demonstrating knowledge in HIPPA compliant ICD-9 CM Diagnosis and procedure codes, CPT-4 codes, billing HIPPA compliant claims electronically on standard hospital forms or (alternatively).
Must have working knowledge and proficiency in computer operation.
This individual must be able to work as a team member with job sharing.
Ability to speak clearly and communicate effectively in a pleasant tone to staff and insurance professionals regarding charges, coding and diagnosis problems is essential.
Possess thorough knowledge of claims submission process.
Must have knowledge of the assigned third parties' billing requirements.
Must display professional mannerism and appearance.

Nice To Haves

Graduate of an approved medical secretarial Associate Degree program preferred.

Responsibilities

Coordinates outpatient coding for Medicare, Blue Cross, Medical Assistance, HMO’s, and Commercial Insurance accounts
Reviews registration information for accuracy, verifying each new patients insurance benefits
Complete the “Benefit Explanation Sheet” to go over with patient
Set up and review each patients insurance in TheraOffice
Once therapist locks information and sends to TheraOffice, create electronic and paper claims to send bills out
Upload created claims to Office Ally (Clearinghouse), entering sent claims to Batch Spreadsheet, updating as needed
Review Office Ally daily for accepted and rejected claims
Ensure required signatures are obtained before processing
Review patient bills for reasonableness prior to billing
Ensure payments are received at each appointment to avoid large balances at the end of therapy plan
Review cancellations for any missed appointment fees and bill patients accordingly
Run reports through TheraOffice to review insurance billing balances
Provide weekly reviews of billing to management
Initiate and complete appropriate process for each credentialed employee
Interfaces with others for a mutual understanding and coordination of billing efforts
Perform other duties as required