Billing Office Specialist - Breast Health Network - Edmond

OU Health•Edmond, OK

About The Position

The Billing Office Specialist for the Breast Health Network is responsible for verifying insurance coverage and obtaining authorizations and precertifications for scheduled appointments for new and established patients while supporting patient satisfaction and quality. The role provides customer service to patients and providers, researches and resolves billing inquiries, coordinates estimated patient payments and payment arrangements, and assists with charity and public-aid applications. The specialist maintains call logs, patient billing and insurance records, collection-system notes, and payment journals; generates insurance verification and precertification reports; and performs backup cashiering as needed. The position also supports front-office operations, patient care coordination, administrative reporting, complaint handling, and office opening and closing procedures. The role reports problems or concerns to the Administrative Services Manager and participates in professional development activities.

Requirements

High school diploma or GED.
At least one year of professional work experience.
Ability to communicate effectively with patients, clinical and administrative staff, and the public.
Ability to promote exemplary customer service, customer satisfaction, and member/provider retention.
Demonstrated prioritization, problem-solving, organizational, and detail-oriented skills.
Ability to work independently with limited supervision and effectively as part of a team.
Ability to function in a fast-paced, changing environment with multiple priorities and objectives.
Ability to resolve conflicts professionally while maintaining exemplary customer service.
Ability to evaluate processes and procedures for continuous improvement.
Intermediate word-processing, spreadsheet, and computer software skills.
Knowledge of medical terminology and familiarity with medical practice terminology.
Knowledge of organizational policies, procedures, systems, and objectives, as well as clinic office procedures.
Ability to use computer systems, applications, and office equipment.
Ability to use proper grammar, spelling, punctuation, and sentence structure in correspondence and reports.
Ability to plan, organize, and oversee workflow.
Ability to interpret, adapt, and apply guidelines, policies, and procedures.
Ability to react calmly and effectively in emergency situations.

Nice To Haves

Two or more years of medical office experience.
One year of collections experience.
Knowledge of or experience with Medicaid and Medicare programs.

Responsibilities

Answer incoming calls and resolve inquiries from patients and providers about billing, eligibility, enrollment, provider networks, benefits, appeals, and grievances; triage calls according to established procedures.
Maintain accurate, detailed, and well-documented logs of calls.
Generate insurance verification and precertification reports as requested.
Contact insurance companies to verify patient benefits and precertification requirements.
Use insurance and billing programs, including Passport, Artiva, Onbase, and Host, to research and resolve billing inquiries and establish up-front payment arrangements.
Complete financial analyses, collect estimated patient liabilities, and provide estimates to patients or physicians as requested.
Assist front-office staff with point-of-service collections when applicable.
Help patients arrange payments and complete charity applications; work with outside agencies to help patients apply for Medicaid and state aid.
Enter notes into the collections system for all patient encounters.
Maintain a journal for cash and credit card payments and provide backup cashiering as needed.
Maintain patient billing files, records, related information, and insurance files reflecting updates and changes.
Identify, analyze, and resolve work problems; forward problems or concerns to the Administrative Services Manager.
Maintain a professional image and provide excellent customer service; ensure patients are treated courteously and visitors are screened and directed appropriately.
Coordinate with other staff to support high-quality patient care.
Perform selected administrative duties and compile and condense statistical data for reports and records.
Ensure patient complaints are handled appropriately.
Ensure offices are opened and closed according to established procedures.
Participate in professional development activities.
Perform other duties as required and assigned.