Billing Specialist (3869)

WACO FAMILY MEDICINE•Bellmead, TX

4d•Onsite

About The Position

The Billing Specialist is responsible for maintaining a current knowledge of insurance carrier and/or state program claims filing policies and procedures. This role involves verifying patient demographics and financial coverage, updating information as needed, and researching and verifying patient and/or insurance company and/or state program refunds/recoupments. The specialist will adjust patient accounts to reflect changes in payment responsibility, verify the accuracy of information on paper medical claim forms, and mail them to selected insurance carriers and/or state programs. Additionally, the role includes researching patient charges not automatically assigned to selected insurance carriers and/or state programs, making corrections, and assigning them manually. Maintaining patient accounts, applying GHC program discounts and/or other adjustments as needed, and appealing service charges rejected by selected insurance carriers and/or state programs by resubmitting amended claim forms are key responsibilities. The Billing Specialist will also process claims/vouchers for insurance plans and/or state programs, obtain pre-certifications, prior-authorizations, or referrals for special provider services, and verify motor vehicle or accident information with the patient’s insurance carrier. Maintaining work queues with claim errors, assisting insurance carriers and/or state programs to acquire supplemental patient information, and assisting patients to understand fees for services and billing processes are also part of the role. The specialist will help patients make payment arrangements and find financial assistance, assist outside providers and vendors to obtain physician billing information, and assist employees with billing-related policies and procedures. Communication and support for training issues with billing staff, compliance with all regulations related to the confidentiality of patient information, and maintaining and/or creating new payor and plans are essential. The role requires the ability to manage multiple priorities, handle stress appropriately, communicate clearly and professionally, demonstrate excellent judgment, and commit to the mission, core values, and goals of Waco Family Medicine, including delivering exceptional patient focus with quality, compassion, and respect. Maintaining certifications and website passwords as applicable is also required. Other duties include assisting in scheduling patient appointments, processing billing statements and balance notification letters, assisting patients with payments, providing follow-up on payment arrangements, assisting with daily mail duties, and providing backup support for other billing staff.

Requirements

High School Diploma or Equivalent required
Computer literacy
Knowledge of ICD-10 CM/CPT coding
Knowledge of medical office billing and collection practices
Knowledge of federal/state/local financial assistance programs
Strong interpersonal, oral, and written communication skills
Excellent telephone and customer service skills
Visual and auditory accuracy
Understand/carry out simple/detailed, oral/written instructions
Memorize and retain instructions
Read and interpret detailed specifications

Nice To Haves

College Hours preferred

Responsibilities

Maintain a current knowledge of insurance carrier and/or state program claims filing policies and procedures
Verify patient demographics and financial coverage; update as needed
Research and verify patient and/or insurance company and/or state program refunds/recoupments
Adjust patients accounts to reflect changes in payment responsibility
Verify accuracy of information on paper medical claim forms and mail to selected insurance carriers and/or state programs
Research patient charges not automatically assigned to selected insurance carriers and/or state programs, make corrections and assign manually
Maintain patient accounts; give GHC program discounts and/or other adjustments as needed
Appeal service charges rejected by selected insurance carriers and/or state programs and resubmit amended claim forms
Process claims/vouchers as needed for insurance plans and/or state programs
Obtain pre-certifications, prior-authorizations, or referrals for special provider services as needed
Verify motor vehicle or accident information with patient’s insurance carrier
Maintain work ques with claim errors
Assist insurance carriers and/or state programs to acquire supplemental patient information needed to process claims
Assist patients to understand fees for services and billing processes
Assist patients to make payment arrangements and find financial assistance
Assist outside providers and vendors to obtain physician billing information
Assist employees to understand policies and procedures related to billing matters
Communicate and support training issues with billing staff
Comply with all regulations related to confidentiality of patient information
Maintain and/or create new payor and plans as needed
Able to manage multiple priorities and manage stress appropriately
Communicates appropriately and clearly with a pleasant and professional manner to all
Demonstrates excellent judgment in handling situations not covered by written or verbal instructions
Demonstrates a commitment to the mission, core values, and goals of Waco Family Medicine and its healthcare delivery including the ability to deliver exceptional patient focus with quality, compassion, and respect
Maintain certifications and website passwords as applicable
Assist in scheduling patient appointments
Process billing statements and balance notification letters to patients
Assist patients to make payments on owed balances
Provide follow-up on patient’s payment arrangements
Assist with daily mail duties
Provide backup support for clerks and other billing staff as needed
Other duties as assigned by supervisor