GI Care for Kids
Overview
The Billing and Collections Specialist must be customer service oriented, detail oriented in accounts receivable with insurance companies and self-pays, and possess the ability to manage multiple tasks daily. Must be bilingual (Spanish). Essential Duties
Follow up on all accounts within the timely filing guidelines of the insurance company assigned to the biller. Correcting claim issues, and/or rebilling claims to third party payers. Claims must be corrected and rebilled within the timely refiling guidelines of the insurance company assigned. Write appeal letters. Communicate with all departments (front desk staff, nursing and providers) to ensure appropriate collection of co-pays and self-pay balances prior to patient visits. Contact patients after obtaining authorization to discuss collection of out-of-pocket expenses prior to patient visits. Document appointment desk activity, call guarantors, and communicate balances that need to be collected. Handle inquiries and answer questions for clerical staff, clinical staff, and insurance companies within a 24-hour turnaround time. Daily monitoring of assigned insurance A/Rs, delinquent self-pay accounts, and all assigned work queues (WQs). Meet deadlines for completing all assigned WQs prior to the end of the month. Identify and resolve patient billing questions in the office and on incoming calls to the business office. Daily collection and/or posting of payments from insurance companies and patients as assigned. Review accounts and make recommendations regarding non-collectible accounts when working delinquent and collection accounts. Notify manager of non-collectible self-pays and insurance balances. Verify patient eligibility through various third-party sources. Understand patient benefits from various insurance carriers and determine out-of-pocket and in/out-of-network status prior to visits in the office. Document payments collected, A/R, and phone call resolutions in the software system. Understand fee schedules and update the manager of fee schedule changes and effective dates timely. Monitor changes in policy and fee schedules for all assigned insurance carriers and inform the manager. Answer business office phone calls daily and on a rotating weekly schedule. Explain out-of-pocket expenses to guarantor. Assist in enrollment and explain drug rebate programs such as Care Path and Entyvio Connect and Pfizer. Assist patients in completing paperwork, explain and follow up on patient assistance programs when needed. Communicate effectively with professional staff and patients. Daily monitoring of personal business office phone line, phone calls and emails. Ensure voicemails are returned within a 24-hour time period. Respond to all emails and staff messages from management, staff and patients within a 24-hour time period. Daily collection of business office mail, and routing to appropriate billers. Filing of manually posted payments. Cross-trained to fill in for other job functions on an as-needed basis. Additional duties as assigned by management. Education, Experience, and Qualifications
Associate’s degree, or equivalent, 3 to 5 years related experience, or Medical Billing Certification. Experience working with medical payers including Medicaid, CMOs and Commercial insurance. Working knowledge of medical billing systems, particularly Epic. Working knowledge of CPT and ICD-10 coding systems. Ability to research and solve AR disputes. Customer service oriented. Productive, dependable, self-starter. Excellent organizational skills. Proficiency in Microsoft Office Suite. Excellent verbal and written skills. Knowledge of medical billing/collection practices required. Strong keyboard skills. Works well in an environment with firm deadlines; results oriented. Ability to perform multiple tasks effectively. Able to work both independently and as part of a team. Strong analytical skills. Competencies
Ethics – Treats people with respect; keeps commitments; inspires trust; acts with integrity. Customer Service – Manages difficult or emotional customer situations; responds promptly to customer needs. Interpersonal Skills – Focuses on solving conflicts; maintains confidentiality; listens to others without interrupting. Organizational Support – Follows policies; completes administrative tasks accurately and on time; supports organizational goals. Teamwork – Balances team and individual responsibilities; participates in building a positive team spirit. Physical Demands and Work Environment
Frequent sitting, grasping, and speaking. Occasional reaching, bending, and stooping. Frequent use of computer, keyboard, copy/fax machine, and phone. Possible exposure to infectious specimens (blood or bodily fluids or airborne pathogens). May be required to wear Personal Protective Equipment (PPE). Noise level is usually quiet to moderate. Fast-paced environment with occasional high-pressure or emergent situations. Work hours subject to office needs to ensure coverage during all hours of operation. Location and salary information are provided for context where available. Referrals may increase your chances of interviewing. Get notified about new Billing Specialist jobs in Atlanta, GA.
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The Billing and Collections Specialist must be customer service oriented, detail oriented in accounts receivable with insurance companies and self-pays, and possess the ability to manage multiple tasks daily. Must be bilingual (Spanish). Essential Duties
Follow up on all accounts within the timely filing guidelines of the insurance company assigned to the biller. Correcting claim issues, and/or rebilling claims to third party payers. Claims must be corrected and rebilled within the timely refiling guidelines of the insurance company assigned. Write appeal letters. Communicate with all departments (front desk staff, nursing and providers) to ensure appropriate collection of co-pays and self-pay balances prior to patient visits. Contact patients after obtaining authorization to discuss collection of out-of-pocket expenses prior to patient visits. Document appointment desk activity, call guarantors, and communicate balances that need to be collected. Handle inquiries and answer questions for clerical staff, clinical staff, and insurance companies within a 24-hour turnaround time. Daily monitoring of assigned insurance A/Rs, delinquent self-pay accounts, and all assigned work queues (WQs). Meet deadlines for completing all assigned WQs prior to the end of the month. Identify and resolve patient billing questions in the office and on incoming calls to the business office. Daily collection and/or posting of payments from insurance companies and patients as assigned. Review accounts and make recommendations regarding non-collectible accounts when working delinquent and collection accounts. Notify manager of non-collectible self-pays and insurance balances. Verify patient eligibility through various third-party sources. Understand patient benefits from various insurance carriers and determine out-of-pocket and in/out-of-network status prior to visits in the office. Document payments collected, A/R, and phone call resolutions in the software system. Understand fee schedules and update the manager of fee schedule changes and effective dates timely. Monitor changes in policy and fee schedules for all assigned insurance carriers and inform the manager. Answer business office phone calls daily and on a rotating weekly schedule. Explain out-of-pocket expenses to guarantor. Assist in enrollment and explain drug rebate programs such as Care Path and Entyvio Connect and Pfizer. Assist patients in completing paperwork, explain and follow up on patient assistance programs when needed. Communicate effectively with professional staff and patients. Daily monitoring of personal business office phone line, phone calls and emails. Ensure voicemails are returned within a 24-hour time period. Respond to all emails and staff messages from management, staff and patients within a 24-hour time period. Daily collection of business office mail, and routing to appropriate billers. Filing of manually posted payments. Cross-trained to fill in for other job functions on an as-needed basis. Additional duties as assigned by management. Education, Experience, and Qualifications
Associate’s degree, or equivalent, 3 to 5 years related experience, or Medical Billing Certification. Experience working with medical payers including Medicaid, CMOs and Commercial insurance. Working knowledge of medical billing systems, particularly Epic. Working knowledge of CPT and ICD-10 coding systems. Ability to research and solve AR disputes. Customer service oriented. Productive, dependable, self-starter. Excellent organizational skills. Proficiency in Microsoft Office Suite. Excellent verbal and written skills. Knowledge of medical billing/collection practices required. Strong keyboard skills. Works well in an environment with firm deadlines; results oriented. Ability to perform multiple tasks effectively. Able to work both independently and as part of a team. Strong analytical skills. Competencies
Ethics – Treats people with respect; keeps commitments; inspires trust; acts with integrity. Customer Service – Manages difficult or emotional customer situations; responds promptly to customer needs. Interpersonal Skills – Focuses on solving conflicts; maintains confidentiality; listens to others without interrupting. Organizational Support – Follows policies; completes administrative tasks accurately and on time; supports organizational goals. Teamwork – Balances team and individual responsibilities; participates in building a positive team spirit. Physical Demands and Work Environment
Frequent sitting, grasping, and speaking. Occasional reaching, bending, and stooping. Frequent use of computer, keyboard, copy/fax machine, and phone. Possible exposure to infectious specimens (blood or bodily fluids or airborne pathogens). May be required to wear Personal Protective Equipment (PPE). Noise level is usually quiet to moderate. Fast-paced environment with occasional high-pressure or emergent situations. Work hours subject to office needs to ensure coverage during all hours of operation. Location and salary information are provided for context where available. Referrals may increase your chances of interviewing. Get notified about new Billing Specialist jobs in Atlanta, GA.
#J-18808-Ljbffr