Billing Specialist - Follow-Up (No-Fault & Workers Comp)

Dent Neurologic Group LLP•Town of Amherst, NY

3d•Onsite

About The Position

Dent Neurologic Institute is committed to excellence in all we do. Our culture is built on 4 key pillars: respect, quality, productivity, and well-being. By remaining dedicated to these values and the overall mission, we are dedicated to making a difference for both patients and colleagues. When you join the Dent team, you can take advantage of a variety of benefits: Work-Life Balance (no overnight shifts), Medical, Dental & Vision Plans, Life Insurance, 401(k) Retirement Plan, Critical Illness, Accident, & Legal Plans, Wellness Program, Learning & Development Opportunities, Paid Time Off, Paid Holidays, Free Onsite Parking at All Locations. Working Schedule: Full-time, Monday - Friday, 8:30 am to 5:00 pm. Location: Amherst. Position Summary: Under direct supervision, is responsible for initiating and coordinating a specific function of Follow-up to review and collect on all submitted medical claims.

Requirements

Must have understanding of the different insurance plans, contracts and policies.
Must know how to interpret EOB’s, understand copay, co-insurance, deductibles and retractions.
Knowledge of other billing process such as claims management, charge entry, payment posting and patient financial clearance
Knowledge of insurance verification process, referral and authorizations requirements.
Knowledge of electronic claim submission
Understanding of patient check-in/check-out process along with a working knowledge of CPT, ICD-9, ICD-10, HCPCs and Modifiers.
Previous working experience in an outpatient medical practice
Medical Terminology
Strong sense of urgency to work within deadlines
Ability to prioritize multiple tasks simultaneously in an occasionally stressful environment.
Strong general office skills, including typing skills
Strong customer service, planning, problem solving and organizational skills
Working knowledge of Microsoft windows programs including Excel and Word
Working knowledge of general office equipment including multi-line phone, computer, copier, calculator, and fax machines
Effective communication and interpersonal skills
High school diploma with a minimum of 2 years of Medical Billing experience

Nice To Haves

Associates Degree in Medical Billing and Reimbursement with a minimum of 1 years of Medical Billing experience

Responsibilities

Follow up and Denial process
Research and following up on outstanding receivables via telephone, provider inquiry form and written correspondence. Document every claim with current status of appeal, as well as call reference numbers and/or insurance representative information.
Very dependent on technology to accomplish tasks efficiently and effectively, must have working knowledge of computer applications such as Word, Excel, and internet browsers to access various insurance carrier websites for updates and insurance procedures/treatment policies. Staff is to utilize all available resources and correct and appeal claims including documentation of the service, medical literature, pre-certification, authorizations, procedure and diagnosis coding manuals, and reference materials.
Understanding of payer appeal process when claims appeal efforts do not succeed, must know when and how to move to a formal appeal process. The formal appeals process varies by each payer. Must understand the reason for the denial and the nature of the appeal, constructing a successful appeal letter, and knowing what to include within each appeal.
Work assigned Insurance Denial Bucket
Work assigned Follow-up claims
Working Medicaid claims by putting them through epaces
Responsible for working 45, 90,120+ day aging claims
Negative Balance Claims and Refunds
Meeting claim filing deadlines
Printing HCFA claims
EBO report generated every Monday for patients with Balances.
Process Medical Expense Reports.
Sort mail appropriately and working Insurance correspondence
Strict adherence to Dent policies, Refund policies and other Accounts receivable policies is required.
Performs other duties assigned by Billing Manager, Team Lead, Sr. Revenue Cycle Manager or CFO.
Answer all phone calls in an effort to assist patients with billing questions
Ability to accept responsibility for appropriate conduct within the office setting and with other department associates by interacting calmly, respectfully and in a friendly manner with other representatives of services at Dent
Maintains strict confidentiality of patient information.
Completes duties in a time efficient manner as set forth by the Team Leader. Reports errors or problems so that appropriate action may be taken for patient care.