Medical Billing/Financial Counselor

SENT Management Services LLC•Sacramento, CA

13d•$23 - $27•Onsite

About The Position

Originally established in 1957, Sacramento Ear, Nose & Throat’s (SacENT) award-winning physicians are nationally recognized leaders in their fields. At SacENT, the mission of the physicians and staff is to provide the highest standard of state-of-the-art specialty medical care in a personal, compassionate manner. This position is responsible for submitting medical claims to insurance companies and payers such as Medicare and Medicaid. The role involves gathering charge information, coding, entering/verifying data in the Practice Management System, completing the billing process, and distributing billing information. Additionally, the position is responsible for reviewing and communicating insurance coverage and benefits for individual patients.

Requirements

Working knowledge of EOB’s ,EFT’s and ERA’s
Working knowledge of ICD-9/10& CPT Codes
Working Knowledge of health insurance denial processing
Must be familiar with insurance eligibility requirements
Able to think and act independently on assigned tasks.
Demonstrates increasingly more ability to troubleshoot and solve overall issues.
Knowledge of HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Use of computer systems, software, 10 key calculators
Effective communication abilities for phone contacts with insurance payers to resolve issues
Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds
Able to work in a team environment
Problem-solving skills to research and resolve discrepancies, denials, appeals, collections
Knowledge of accounting and bookkeeping procedures
Knowledge of medical terminology likely to been countered in medical claims
Medical Billing: 3 years (Required)
Medical Insurance: 2 Years (Required)

Nice To Haves

EPIC Preferred

Responsibilities

Research all information needed to complete billing process including getting charge information from physicians.
Codes information about procedures performed and diagnosis on charge.
Keys charge information into on-line entry program and produces billing.
Works with other staff to follow-upon accounts until zero balance or turned over for collection. Patient outstanding balance follow ups.
Assists with coding and error resolution.
Assists with answering the telephone and provides information as requested. Assist with reviewing and communicating insurance coverage and benefits for individual patients.
Maintains required billing records, reports, files.
Identifies delinquent accounts, aging period and payment sources. Processes delinquent unpaid accounts by contacting patients and third party responsible for reimbursement.
Performs various collection actions including contacting patients by phone and resubmitting claims to third party responsible for reimbursement.
Evaluates patient financial status and establishes budget payment plans. Follows and reports status of delinquent accounts.
Reviews accounts for possible assignment makes recommendation to Billing Supervisor and prepares information for collection agency.
Assigns uncollectible accounts to collection agency or attorney via clinic Credit and Collection policy. Contacts lawyers involved in third-party litigation.
Answers inquiries and correspondence from patients and insurance companies. Using Clinic approved correspondence letters.
Identifies and resolves patient billing complaints, and research credit balances.
Participates in educational activities.
Maintains strictest confidentiality.
Other duties as assigned.