Billing Specialist

Brandywine Urology Consultants•New Castle, DE

2h•Onsite

About The Position

The Billing Specialist enters charges and posts payments and account adjustments for assigned physicians' professional services in the practice management system. The role is responsible for balancing and filing batches, reviewing coding for Medicare compliance, verifying patient demographic and insurance information, submitting claims, reconciling deposits, and following up on insurance claims and patient account balances. The specialist also responds to patient account inquiries, supports physicians and managers with billing and reimbursement information, processes refunds, monitors reimbursement against contracted rates, and maintains organized reference information and a professional work environment. The position requires adherence to practice policies, including OSHA, HIPAA, and Medicare Compliance, and attendance at relevant seminars to stay current on applicable issues.

Requirements

Two years of medical billing experience required.
High school or equivalent education preferred.
Ability to use facets of a medical practice management system, including patient registration, charge entry, insurance processing, advanced collections, reports, and ledger inquiry.

Nice To Haves

Two years of medical collection experience.

Responsibilities

Enter charges for assigned physicians' professional services, including office and hospital charges, and ensure charge batches balance by procedure count and total amount before posting.
Post line-item payments, including co-payments, insurance payments, and patient payments, and balance payment batches by payment and adjustment amounts before posting.
Post patient-account credit and debit adjustments according to the Procedure Manual.
File charge, payment, and adjustment batches by batch date in the appropriate format.
Review physician coding during charge entry for Medicare compliance and accurate, timely reimbursement.
Provide telephone and in-office customer service to patients and authorized representatives regarding patient accounts.
Return patient calls about accounts receivable within two business days.
Verify demographic and insurance information during charge entry, and provide feedback to front-office staff as needed.
Follow up on outstanding insurance claims at 30, 45, and 60 days from the date of service.
Follow up on outstanding patient balances at 35, 60, 90, and 120 days from the date of service using A/R aged reports.
Provide physicians and managers with information about billing, coding, managed care networks, insurance carriers, and reimbursement.
Follow up on returned claims, correspondence, denials, account reconciliations, and rebills within five working days of receipt.
Submit primary and secondary insurance claims electronically each day and submit claims on HCFA forms semi-weekly.
Attend relevant seminars to remain current on obstetric and/or gynecology accounts receivable, Medicare Compliance, and HIPAA issues.
Recommend accounts for outside collection when internal collection efforts fail.
Process refunds to insurance companies and patients.
Reconcile incoming lockbox deposits as required.
Monitor reimbursement from managed care networks and insurance carriers for consistency with contract rates.
Use the medical practice management system for patient registration, charge entry, insurance processing, advanced collections, reports, and ledger inquiry.
Maintain organized, accessible information on coding, insurance carriers, managed care networks, and credentialing.
Maintain an organized, efficient, and professional work environment.
Adhere to practice policies related to OSHA, HIPAA, and Medicare Compliance.
Perform other duties as assigned.