Billing Support Specialist - Anesthesiology

SB Clinical Practice Management Plan•Stony Brook, NY

9d•Onsite

About The Position

The Billing Support Specialist will be responsible for capturing missing charges and clearing claims that are in holding, assisting the CPMP Central Billing Office in resolving denials. This role involves reviewing the system for unprocessed or unpaid claims, using the EMR to review charts and communicate with physicians for chart completion, and capturing missing charges in Patient Keeper. The specialist will maintain work files for coding and billing errors, review the task manager for insurance denials, and identify reimbursement issues by reviewing payer payments and Explanation of Benefit documentation. Additionally, the role includes preparing billing error corrections, reconciling visits with completed coding, entering coding data into the Patient Keeper billing interface, and providing data to CPMP Patient Accounts for patient inquiries. The specialist will also analyze, code, and abstract information for assigning diagnoses and procedure codes, resolve coding-related discrepancies, maintain PK files for validity errors, and monitor the TES Open Encounter file. Other duties include completing special department/physician projects as assigned by management.

Requirements

High School Diploma/GED
Minimum of three years of medical billing related experience in a physician’s office.
Computer literate with knowledge of medical insurance policies, reimbursement and medical terminology.
Experience with Electronic Medical Record system.
Working knowledge of coding requirements
Must be proficient in Microsoft Office Word and Excel
Healthcare experience

Nice To Haves

Bachelor’s degree
Medical Billing & Coding Certificate.

Responsibilities

Capture missing charges and clear claims that are in holding.
Assist CPMP Central Billing Office in resolving denials.
Review system for unprocessed claims/unpaid claims.
Using EMR, review charts and send messages to physicians providing specific information required for completing charts.
Capture missing charges in Patient Keeper.
Maintain work files for coding and billing errors.
Review task manager for insurance denials.
Identify reimbursement issues - Review payer payments –Review Explanation of Benefit documentation.
Prepare billing error corrections.
Reconcile visits per schedule with completed coding and identify any unbilled visits.
Enter coding data into the Patient Keeper billing interface.
Provide data to CPMP Patient Accounts as requested for patient inquiries.
Analyze, code and abstract information for the purpose of assigning and entering appropriate and consistent diagnoses and procedure codes for reimbursement.
Resolve discrepancies on coding-related issues.
Maintain PK files for validity errors.
Monitor TES Open Encounter file.
Perform all other duties as assigned by management.
Complete special department/physician projects.