Medical Billing Specialist

ASSOCIATED RETINA CONSULTANTS•Peoria, AZ

5d•Onsite

About The Position

Associated Retina Consultants is seeking an organized, efficient Medical Billing Specialist with strong attention to detail and accuracy. The role is responsible for posting insurance payments, entering charges, and assisting patients with their accounts. It requires thoroughness and a good understanding of insurance procedures for referrals, co-pays, deductibles, allowable amounts, CPT codes, and diagnosis codes. The position is based in the Peoria office in Peoria, Arizona, and is full-time on the day shift, with no travel listed. The specialist works with confidential patient information and maintains its accuracy and completeness. The role includes verifying and submitting claims, following up on unpaid and denied claims, supporting patients and insurance companies with billing questions, and complying with applicable payer processes and regulations. Additional functions and requirements may be assigned by supervisors as appropriate. Associated Retina Consultants is an Equal Opportunity Employer.

Requirements

High school diploma or equivalent required.
Knowledge of insurance guidelines, including HMO/PPO, Medicare, Medicaid, and other payer requirements and systems.
Proficiency in Microsoft Word, Outlook, and Excel, and use of 10-key calculators.
Basic knowledge of medical terminology, including CPT and ICD-10 coding.
Effective communication abilities for phone contacts with insurance payers to resolve issues.
Knowledge of medical terminology likely to be encountered in medical claims.
Ability to maintain patient confidentiality in accordance with HIPAA.
Planning and organizing skills.
Attention to detail, accuracy, and efficiency.
Problem-solving skills.
Teamwork and multitasking abilities.
Customer service skills.
Electronic Medical Records (EMR) skills.
Verbal and written communication skills.
Integrity.

Nice To Haves

Two or more years of medical billing experience preferred.

Responsibilities

Work with personal information while maintaining patient confidentiality.
Prepare weekly and monthly reports for the executive director and billing supervisor.
Verify claims for accuracy before submission and submit claims with a goal of zero errors.
Review claims and denials to help ensure maximum reimbursement for services provided.
Use monthly accounts receivable aging reports to follow up on unpaid claims aged over 30 days.
Review referrals and authorizations.
Respond to questions and complaints from patients and insurance companies.
Research and appeal denied claims.
Read and interpret insurance explanations of benefits and respond to inquiries from insurance companies, patients, and providers.
Meet defined department goals and activity metrics.
Initiate late-payment notices to relevant parties.
Identify and bill secondary and/or third-party insurance.
Follow established billing processes and procedures and applicable Medicare, state program, and HMO/PPO regulations and guidelines.
Ensure patient information is accurate and complete, and request missing information.
Create paper and electronic copies of documentation.
Collect delinquent accounts by establishing payment arrangements with patients, monitoring payments, and following up when payments lapse.
Perform other responsibilities as judgment or necessity dictate.