Billing & Collections Specialist I

U.S. Oral Surgery ManagementIrving, TX
$24 - $26Onsite

About The Position

The primary duties and responsibilities include the ability to follow up with insurance and/or patient balances. Actively reach out to patients to discuss outstanding balances when denied by insurance and collect balances. Research denials and rejections and correct the claims to rebill. Communicate with and support other RCM staff, patients, partner practices, and insurance companies to maximize reimbursement and ensure rapid account resolution.

Requirements

  • Ability to manage multiple priorities with frequent interruptions
  • Excellent oral and written communication skills
  • Ability to meet deadlines
  • Problem-solving skills
  • Exceptional human relations skills
  • Must be a team player
  • Proficient in use of computers and Patient Management Software
  • Adding and subtracting math skills
  • Must possess knowledge of EOB’s and understand co-pay, coinsurance, deductibles, and denial codes
  • Attention to detail and can prioritize independently
  • Intermediate knowledge of MS Office
  • Ability to understand fee schedules
  • Able to audit an account from start to finish with little help
  • High School diploma, GED or equivalent
  • An equivalent combination of education and experience is acceptable
  • 2+ years of experience in medical/dental billing/collections or office experience

Responsibilities

  • Communicate with patients, practice partners, and coworkers by answering telephone, emails, and TEAMs messages to assist with any questions or apprehensions regarding balances, billing, collections, and reimbursement.
  • Utilize MY Transworld Health website to send patient accounts to profit recovery and collections. Update My TSI with additional information regarding patients’ failure to pay remaining balances if a patient submits a dispute.
  • Send emails with statements to update patients on remaining balances and bad debt.
  • Maintain a record for practice with all sent statements and emails regarding billing to patients.
  • Update billing systems to reflect the status of collection and patient payments.
  • Identify possible issues or concerns that may impede insurance/patient payments and collaborate with the manager to construct a resolution for the issue.
  • Provide a thorough explanation of benefits to patients, and properly explain the reasoning behind balances and collections.
  • Run aging reports weekly, monitor buckets which include money in insurance claims that still need to be collected, and follow up with insurance to find the reasoning behind outstanding, rejected, or pending claims. Review errors and provide resolution to issues.
  • Initiate a review of patient accounts with credit balances and issue refunds when necessary.
  • Ensure insurance pays correctly and issue adjustments following state law and USOSM protocol.
  • Create contact notes with reminder dates to ensure claims are followed up on timely.
  • Pull zero pays and apply insurance adjustments, updating the billing category.
  • Follow appropriate procedures before moving a patient's balance to a collection agency.
  • Process/or give to the poster any credit cards when taken over the phone.
  • Communicate with the practice on accounts needing discretionary adjustments posted.
  • Maintain an accuracy rate of 97% or better.
  • Perform additional duties as assigned by the manager or director.
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