Medical Billing Specialist

American Health Partners•Franklin, TN

49d

About The Position

The Medical Billing Specialist for Nurse Practitioners is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts. ESSENTIAL JOB DUTIES: To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation. Extract and verify billing information from medical records Ensuring collection of past due balances; follow up as needed Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies Answer patient account inquiries; assists establish alternative payment plans when necessary Maintain patient account records; settle third party payer issues as required Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS) Prepare and review patient statements prior to release through PMS Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims Balance daily charges; reconcile with reports within PMS Collaborate with revenue cycle manager and payers on denials/rejections Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained Other duties as assigned

Requirements

Problem solving skills to manage a variety of concrete variables
Effective verbal and written communication skills
Ability to interpret instruction presented in variety of situations
Strong organizational skills; ability to manage multiple projects simultaneously
Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
Ten key speed and accuracy

Responsibilities

Extract and verify billing information from medical records
Ensuring collection of past due balances; follow up as needed
Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies
Answer patient account inquiries; assists establish alternative payment plans when necessary
Maintain patient account records; settle third party payer issues as required
Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
Prepare and review patient statements prior to release through PMS
Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims
Balance daily charges; reconcile with reports within PMS
Collaborate with revenue cycle manager and payers on denials/rejections
Work closely with practice representatives to ensure proper insurance verifications and authorizations are obtained
Other duties as assigned
Comply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
Communicate professionally with patients and guarantors regarding balances or account information
Participate in required orientation and training programs
Cooperate with monitoring and audit functions and investigations
Participate in process improvement responsibilities
Meet productivity goals
Successful completion of required training
Handle multiple priorities effectively