Physician Practice Billing Specialist

Garnet Health•Middletown, NY

2d•Onsite

About The Position

Under supervision and through the use of the Physician Billing’s medical claim billing software, Epic, the Physician Practice Billing Specialist is primarily responsible for communicating with all insurance carriers. This position is also responsible for researching insurance company issues, such as network problems, workers compensation claims, and a variety of special projects. This position requires a comprehensive understanding of the operational aspects of the entire revenue cycle as well as the appropriate measures to take in resolving claim issues with payers. Proactively contact carriers regarding reduced or denied reimbursement; ensure patient insurance information is accurate. Retrieve various types of medical documentation. Develop, submit, and track appeals to carriers, per department procedure. Review and analyze explanation of benefits, and adjust patients’ accounts to reflect the carrier’s decisions on the patient’s statement. As a Payment Posting Specialist receives and accurately records all SBO patient pays and third-party mail payments for services rendered using the Physician Billing’s medical claim billing software, Epic. Ensures data input has been recorded properly and timely by reconciling to daily reports. Must be able to balance bank deposits.

Requirements

High School diploma or High School Equivalent or Associate Degree (preferred).
Three years of billing experience needed.
Multi-specialty practices/facilities experience preferred.
Should understand third-party healthcare reimbursement regulations.
Basic knowledge of Medical Terminology, ICD-10, and CPT coding.
Excellent communication, interpersonal, analytic, organizational, and problem-solving skills.
Must be PC and Microsoft Office proficient and must be able to access specialized healthcare websites via the World Wide Web.
Work is sedentary with intermittent walking and standing, visual acuity and ability to communicate with others.
Ability to foster collaborative relationships, to work well under pressure, to organize and synthesize new information, and prioritize tasks.
Possesses critical thinking, analytical skills and flexibility.
Ability to multi-task.
Required detailed attention to work in an environment where interruptions cannot be controlled.
Demonstrates sensitivity to customer needs and expectations.

Nice To Haves

Associate Degree

Responsibilities

Communicating with all insurance carriers.
Researching insurance company issues, such as network problems, workers compensation claims, and a variety of special projects.
Proactively contact carriers regarding reduced or denied reimbursement.
Ensure patient insurance information is accurate.
Retrieve various types of medical documentation.
Develop, submit, and track appeals to carriers, per department procedure.
Review and analyze explanation of benefits, and adjust patients’ accounts to reflect the carrier’s decisions on the patient’s statement.
Receive and accurately record all SBO patient pays and third-party mail payments for services rendered using the Physician Billing’s medical claim billing software, Epic.
Ensures data input has been recorded properly and timely by reconciling to daily reports.
Balance bank deposits.