Billing Specialist

Dent Neurologic Group LLP•Amherst, NY

75d•Onsite

About The Position

Join our growing team! Under direct supervision, the Medical Billing A/R Specialist plays a key role in driving the success of our revenue cycle by initiating and coordinating all functions related to collecting on medical claims. This is a great opportunity for a motivated, detail-oriented individual looking to build or grow a career in healthcare administration. We are willing to train the right candidate, and prior experience in medical billing, accounts receivable, or healthcare revenue cycle is a plus.

Requirements

Basic understanding of insurance plans, contracts, and policies preferred; willing to train the right candidate
Familiarity with interpreting EOBs, including copays, coinsurance, deductibles, and retractions is a plus
Knowledge of billing processes such as claims management, charge entry and payment posting preferred but not required
Exposure to insurance verification processes, referrals, and authorization requirements is a plus
Familiarity with medical terminology is a plus
Strong sense of urgency and ability to meet deadlines
Ability to prioritize and manage multiple tasks in a fast paced environment
Strong customer service, organizational, and problem-solving skills
General office skills, including typing and data entry
Working knowledge of Microsoft Office (Excel, Word)
Familiarity with general office equipment (multi-line phone, copier, fax, etc.)
Effective communication and interpersonal skills
Willingness to learn and be trained in medical billing and accounts receivable processes
High school diploma with a minimum of 2 years of Medical Billing experience

Nice To Haves

prior experience in medical billing, accounts receivable, or healthcare revenue cycle is a plus
Familiarity with interpreting EOBs, including copays, coinsurance, deductibles, and retractions is a plus
Knowledge of billing processes such as claims management, charge entry and payment posting preferred but not required
Exposure to insurance verification processes, referrals, and authorization requirements is a plus
Familiarity with medical terminology is a plus
Associates Degree in Medical Billing and Reimbursement with a minimum of 1 years of Medical Billing experience

Responsibilities

Perform follow-up and manage denied claims by working assigned insurance denial buckets and follow-up queues.
Research and follow up on outstanding receivables via telephone, written correspondence and electronic portals; document all activity including claim status, appeal progress, call reference numbers, and insurance representative details
Utilize computer systems and payer websites to access claim status, send inquiries and appeals, insurance procedures, and treatment policies
Use all available resources to resolve claims, including documentation, medical records, authorizations, coding manuals, and reference materials
Understand payer-specific appeal processes, including when to escalate to formal appeals
Analyze denial reasons, prepare and submit effective appeal letters, and ensure proper supporting documentation is included
Meet timely filing deadlines for all claims and ensure timely resolutions
Manage accounts receivable across aging buckets (45, 90, 120+ days)
Resolve negative balance claims and process refunds as needed
Manage insurance correspondence sent in via mail
Ensure strict adherence to organizational billing, refund, and accounts receivable policies
Answer patient calls regarding billing questions in a professional and helpful manner
Maintain professional, respectful communication with patients, team members, and other departments
Maintain strict confidentiality of patient information in accordance with HIPAA regulations
Complete duties efficiently as directed by leadership and report errors or issues promptly
Perform additional duties as assigned by Billing Manager, Team Lead, Sr. Revenue Cycle Manager, or CFO
Posts all charges, including inpatient and outpatient services in accordance with current ICD-9 and CPT coding.
Verifies all pending encounters have been addressed and entered accordingly.
Registers patients in billing system when necessary (i.e. in-patient).
Ensures insurance and claim accuracy.