BUSINESS OFFICE SPECIALIST (Billing)

Sun Life Health•Casa Grande, AZ

10d•Onsite

About The Position

STATEMENT OF PURPOSE: To provide accounts receivable management services; including payment posting and claims follow-up. ESSENTIAL FUNCTIONS: 1. Manage the effective use of the Owner Lists in practice management system in the daily management of receivables: Work Denial Review & Mail Work aging accounts, focus on resolving aging buckets >61 days/high dollar accounts first Work all miscellaneous work. Miscellaneous includes write-offs, appeals, refunds, medical records requests 2. On assigned payment days: Obtain all copies of mail check E.O.B.s and patients payment remittance advices. These may be hard copies or from the clearinghouse and other available websites Post all insurance payments to the proper patients account in the practice management system Run day sheet from the practice management system and daily summary from Access on a daily basis, after posting is complete. Reconcile the sum of these two reports to the bank deposit slip for that day using the Daily Cash Reconciliation and report any irreconcilable differences to the Business Office Manager Update patient demographics per E.O.B. information, when necessary 3. Make recommendations to the Business Office Manager when the need for improvements is noted in any area affecting accounts receivable 4. Monitor claims on an ongoing basis to ensure payment prior to or at 60 days aging as the goal. 65% of the A/R should reside in the 0-30 and 31-60 days buckets 5. Monitor for unacknowledged claims and ensure that they are re-billed in a timely manner 6. Participate with billing office personnel in the correcting and rebilling process of all claims not adjudicated upon initial billing 7. Keep the Business Office Manager up-to-date on statistical information regarding the correcting and rebilling process of all claims not adjudicated upon initial billing 8. Design and manage appropriate feedback loops so that the issues discovered as causing payment delays are not perpetually repeated 9. Notify the Business Office Manager when charges, payments or adjustments are not being correctly dispersed in the practice management system 10. Participate in group projects as needed to correct billing issues in the practice management system and related software

Requirements

High School diploma or equivalency
Five years experience in a Medical Office billing environment
Courses in medical terminology and coding
Experience in problem solving and the use of analytical skills
Computer literate

Responsibilities

Manage the effective use of the Owner Lists in practice management system in the daily management of receivables
Work Denial Review & Mail Work aging accounts, focus on resolving aging buckets >61 days/high dollar accounts first
Work all miscellaneous work. Miscellaneous includes write-offs, appeals, refunds, medical records requests
Obtain all copies of mail check E.O.B.s and patients payment remittance advices
Post all insurance payments to the proper patients account in the practice management system
Run day sheet from the practice management system and daily summary from Access on a daily basis, after posting is complete.
Reconcile the sum of these two reports to the bank deposit slip for that day using the Daily Cash Reconciliation and report any irreconcilable differences to the Business Office Manager
Update patient demographics per E.O.B. information, when necessary
Make recommendations to the Business Office Manager when the need for improvements is noted in any area affecting accounts receivable
Monitor claims on an ongoing basis to ensure payment prior to or at 60 days aging as the goal. 65% of the A/R should reside in the 0-30 and 31-60 days buckets
Monitor for unacknowledged claims and ensure that they are re-billed in a timely manner
Participate with billing office personnel in the correcting and rebilling process of all claims not adjudicated upon initial billing
Keep the Business Office Manager up-to-date on statistical information regarding the correcting and rebilling process of all claims not adjudicated upon initial billing
Design and manage appropriate feedback loops so that the issues discovered as causing payment delays are not perpetually repeated
Notify the Business Office Manager when charges, payments or adjustments are not being correctly dispersed in the practice management system
Participate in group projects as needed to correct billing issues in the practice management system and related software