Billing Specalist

Brandywine Urology Consultants•New Castle, DE

7d•Onsite

About The Position

The Billing Specialist is responsible for accurately inputting charges, posting payments, and managing patient accounts to ensure timely reimbursement and maximum patient satisfaction. This role involves reviewing coding for compliance, providing customer service, verifying patient information, and following up on outstanding claims and balances. The specialist will also communicate billing information to physicians and managers, process refunds, reconcile deposits, and monitor reimbursement rates. Proficiency with the medical practice management system and maintaining an organized work environment are key. Adherence to OSHA, HIPAA, and Medicare Compliance policies is required.

Requirements

Medical billing: 2 years (Required)
Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.
Adherence to all practice policies related to OSHA, HIPAA and Medicare Compliance.

Nice To Haves

High school or equivalent (Preferred)
Medical collection: 2 years (Preferred)

Responsibilities

Input all charges related to the assigned physician's professional services into the practice management system, including office and hospital charges, ensuring accuracy for timely reimbursement and patient satisfaction.
Post all payments, by line-item, received for physician's professional services into the practice management system, including co-payments, insurance payments, and patient payments, ensuring accuracy for patient satisfaction and profitability.
Post all credit and debit adjustments to patient accounts following the guidelines in the Procedure Manual.
File all charge, payment, and adjustment batches in the appropriate format by batch date for quick reference.
Review the physician's coding at charge entry to ensure compliance with Medicare guidelines and accurate, timely reimbursement.
Provide customer service via telephone and in person to patients and authorized representatives regarding patient accounts.
Return patient calls regarding accounts receivable within 2 business days.
Verify all demographic and insurance information in patient registration of the practice management system at the time of charge entry to ensure accuracy and provide feedback to front office staff.
Follow-up on all outstanding insurance claims at 30, 45, and 60 days from the date of service to maximize patient satisfaction and practice profitability.
Follow-up on all outstanding patient account balances at 35, 60, 90, and 120 days from the date of service using A/R aged reports.
Provide information pertaining to billing, coding, managed care networks, insurance carriers, and reimbursement to physicians and managers.
Follow-up on all returned claims, correspondence, denials, account reconciliations, and rebills within five working days of receipt to achieve maximum reimbursement in a timely manner.
Submit primary and secondary insurance claims electronically each day and on HCFA semi-weekly.
Attend relevant seminars to stay updated on obstetric and/or gynecology accounts receivable, Medicare Compliance, and HIPAA.
Recommend accounts for outside collection when internal collection efforts fail.
Process refunds to insurance companies and patients.
Reconcile incoming lockbox deposits to ensure timely payment posting.
Monitor reimbursement from managed care networks and insurance carriers to ensure reimbursement consistent with contract rates.
Maintain proficiency with all facets of the medical practice management system.
Maintain organized, easy-to-reference information regarding coding, insurance carriers, managed care networks, and credentialing.
Maintain an organized, efficient, and professional work environment.
Adhere to all practice policies related to OSHA, HIPAA, and Medicare Compliance.
Perform other duties as assigned.