Medical Billing Specialist II - Experience in AR Aging

Fogg Remington EyeCare•Fresno, CA

About The Position

A successful Medical Billing Specialist (MBS) is responsible for actions that support and safeguard Fogg Remington EyeCare (FRE) Standard of Patient Care. As an MBS, you will juggle multi-tasks simultaneously and regularly complete ad hoc projects. The workday goes by quickly, and no two days are exactly alike. The MBS should be committed to the Company’s strong learning culture and creating a positive patient experience. An MBS is responsible for managing the billing process, ensuring that claims are processed accurately and in a timely manner. The MBS will prepare and submit claims to insurance companies and other third-party payers.

Requirements

Possession of a high school diploma or GED.
Although previous experience as a Medical Billing Specialist is ideal, healthcare, hospitality, and retail experience are also assets.
Good interpersonal skills and the ability to communicate effectively with different audiences.
Intermediate to advanced phone skills; able to effectively relate via the telephone and in-person to serve the needs of Clinic patients/clients/visitors in an efficient and productive manner.
Fluent in medical terminology used and referenced in the billing of services.
Strong written and verbal communication.
Ability to gracefully assist unhappy customers.
Ability to interact and work effectively with co-workers, clients, guests, volunteers, and others.
Well-spoken and polished demeanor.
Cultural sensitivity and demonstrated ability to work with diverse people groups.
Attention to detail requires a high level of accuracy and attention.
Time management and organizational skills: prioritizing tasks, meeting deadlines, and staying organized.
Problem-solving skills: Analyzing complex problems, developing creative solutions, and making sound decisions.
Proficiency with Microsoft 365 (Microsoft Word/Excel/Outlook).
Must have valid California driver’s license (required).

Nice To Haves

Ophthalmic Coding Specialist Certification (OCS) and/or completion of a Medical Assistant or comparable program.

Responsibilities

Enter Explanation of Benefit or Payment information from external sources into Practice Management System.
Review and update patient demographics in Practice Management System.
Interact with patients regarding outstanding balances to minimize patient collections.
Identify recurring issues in billing process. Resolve and/or elevate as required.
Follow procedures to produce statements for patients.
Review pre billing reports for conformance with billing requirements and make changes as required.
Process and export claim information and deliver electronically or physically to the appropriate insurance company.
Recognize and speak with insurance staff regarding insurance denials, aged reports, and other billing issues.
Determine the next steps to reprocess claims being appealed or rebill claims that have not been paid.
Enter charges into Practice Management System and review information for accuracy and alignment with proper billing procedure.
Run and review reports to identify errors or post missing charges.
Identify and process unapplied credits.
Process payment information that may not be a 1:1 format to Nextgen system, using best judgement and procedures to accurately post payment information.
Process charges for No Show visits.
Enter optical claims information into the appropriate external insurance system.
Cross-train in relevant/related functions and roles as necessary, and assist/train other staff in related functions as needed.
Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency required.
Maintain confidentiality by safeguarding ePHI and demonstrating HIPAA compliance to our patients.
Ensure that HIPAA privacy policies are clearly understood and followed.
Present a positive view of FRE to the community.
Protect company assets.
Support all co-workers and treat them with dignity and respect.
Support the team to reach common goals.
Be able to think and act quickly and efficiently in emergencies.
May be scheduled to work at different locations as necessary, reporting to the location at beginning of the day.
May drive on company business.
Must have valid California driver’s license (required).
Comply with all FRE policies and procedures, including but not limited to workplace safety, reporting work-related injuries, Infection Control, and preventing potential safety risks for staff, clients, and others.
Punctual and regular attendance is an essential responsibility of each employee at FRE. Employees are expected to report to work as scheduled, on time, and prepared to start working. Employees are expected to remain at work for their entire work schedule. Late arrival, early departure, or other absences from scheduled hours are disruptive and must be avoided.
Other duties as assigned.