Medical Billing & Collections Specialist II

Millennium Physician Group•Fort Myers, FL

About The Position

The Revenue Cycle-CSR is responsible to provide support to patients, providers and customers internally and externally on billing related inquiries. The employee works insurance claims and patient accounts using department guidelines and MPG electronic systems. The position requires a thorough knowledge of insurance carrier billing and reimbursement, CPT, modifiers and fee schedule differences. Also requires understanding of how to decipher explanation of benefits and explain the impact to the customer. Position requires the ability to conduct both telephone, portal and face to face meetings with patients regarding account resolution and payment collection. Assist customers with hardship applications, payment plans and eligibility for services. Expert verbal communication, interpersonal skills and professional appearance required for dealing with customers. Additional duties as required.

Requirements

Demonstrate excellent interpersonal skills with patients, co workers and insurance carriers.
Well-versed with all HIPPA Guidelines to ensure the protection of patient information from unauthorized inquiries.
Advanced knowledge of CPT and modifiers.
Claim adjudication carrier rules knowledge.

Nice To Haves

Thorough knowledge of insurance carrier billing and reimbursement.
Understanding of fee schedule differences.
Expert verbal communication, interpersonal skills and professional appearance required for dealing with customers.

Responsibilities

Provide support to patients, providers, and customers on billing-related inquiries.
Work insurance claims and patient accounts using department guidelines and MPG electronic systems.
Decipher explanation of benefits and explain the impact to the customer.
Conduct telephone, portal, and face-to-face meetings with patients regarding account resolution and payment collection.
Assist customers with hardship applications, payment plans, and eligibility for services.
Process and post payments to accounts same day.
Resolve patient complaints within a minimal timeframe, same day whenever possible.
Reprocess Athena claims after updating the account with new information as provided by patients or physicians within the guidelines and timeframes permitted by the insurance carrier.
Answer phones and return voicemails within same day/next day as per department metrics.
Conducts themselves in accordance with MPG Policies and Procedures including the Code of Conduct.
Meets or Exceeds monthly performance goals, expectations and reviews.
Uses Paid Time Off effectively.
Keeps overtime to a minimum/has any overtime approved by Manager.