Billing & Collections Specialist I

U.S. Oral Surgery Management•Irving, TX

5d•Onsite

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

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
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, co-insurance, 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

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.
Utilizes MY Transworld Health website to send patient accounts to profit recovery and collections.
Updates My TSI with additional information regarding patients’ failure to pay remaining balances if a patient submits a dispute.
Send email with statements to update patients on remaining balances and bad debt.
Maintains a record for practice with all sent statements and emails regarding billing to patients.
Updates billing systems to reflect the status of collection and patient payments.
Identifies possible issues or concerns that may impede insurance/patient payments and collaborates with the manager to construct a resolution for the issue.
Provides a thorough explanation of benefits to patients and properly explains the reasoning behind balances and collections.
Runs aging report weekly, monitors buckets which include money in insurance claims that still needs to be collected, and follows up with insurance to find reasoning behind outstanding, rejected, or pending claims.
Reviews errors and provides resolution to issues.
Initiates review of patient accounts with credit balances and issues refunds when necessary.
Ensures insurance pays correctly and issues adjustments following state law and USOSM protocol.
Create contact notes with reminder dates to ensure claims are followed up on timely.
Pulls zero pay and applies insurance adjustment, updating billing category.
Follows appropriate procedures before moving patients balance to a collection agency.
Processes/or gives to poster any credit cards when taken over the phone.
Communicates with practice on accounts needing discretionary adjustments posted.
Must maintain accuracy rate 97% or better.
Performs additional duties as assigned by manager or director.