Senior Billing Specialist

Job Description

Job Description

Summary : The Senior Billing Specialist is responsible for assisting the Billing Manager and Billing Specialists as well as insurance and patient related issues as discussed below.

Education : Minimum High School Diploma.

Experience : Must have at least two years of experience in a medical office setting, preferably with supervisory responsibilities in a Central Medical Billing office.

Essential Job Functions :

• Maintains confidentiality of all protected health information (PHI) and personally identifiable information (PII).
• Performs job in compliance with organization policies and procedures as well as community standards and applicable laws.
• Promotes positive public relations with patients, visitors, families, physicians, and others. Exhibits characteristics consistent with CPC values for quality, respect, teamwork, and pride.
• Physical appearance and conduct are consistent with acceptable professional ethics and CPC standards.
• Assist Billing Manager with Billing Specialists’ needs and training.
• Assist Managers in creating and implementing workflows to suit CPC needs for Billing Specialists
• Be a collaborative & essential part of the team doing assigned tasks that will help CPC to succeed.
• Be flexible and willing to be redirected into other tasks that may better suit your strengths as identified.
• Having a positive outlook and demeanor in everyday tasks
• Maintain a working knowledge of requirements and guidelines for reviewing claims.
• Provide customer service on the telephone for all patients and authorized representatives regarding patient accounts in accordance with practice protocol doing so with a smile and a joyful attitude.
• Covering for other team members in other areas as needed
• Contribute to any special projects that present themselves at any given moment.
• Communicate with Insurance Provider Reps with any billing related inquiries.
• Proficiency with web-based program for eligibility verification and claim status, to efficiently conduct accounts receivable follow-up and to maximize revenue.
• Performs additional duties and responsibilities, as necessary.
• Proficiency with all facets of the medical practice management system including patient registration, charge entry, insurance processing, advanced collections, reports and ledger inquiry.

Knowledge, Skills, and Abilities :

• Eager and able to embody CPC’s mission, especially to serve joyfully.
• Willing and ready to work collaboratively for the good of the team.
• Knowledge of health system
• Have problem solving abilities.
• General ability to navigate websites and payer portals.
• Working knowledge of Microsoft Office and Excel is beneficial.
• Good written and communication skills with the ability to speak and communicate clearly and effectively.
• Good time management skills
• Ability to multi-task
• Function in a fast-paced work environment
• Be able to provide feedback and suggestions.
• Make goals that are specific and realistic with target dates.
• Monitor progress and have the ability to create new workflows based on progress.

Various Task Areas that have been identified include but are not limited to :

• Performs Worklist cleanup to keep revenue cycle moving.
• Keeping all Patient cases and admin tasks up to date
• Sorting and resolving all paper correspondence.
• Balance related Inquiries processed by Athena.
• Maintaining Zero Pay worklist
• Maintaining the Unpostables table
• Upload any paper or missing remits to Athena.
• Program Payments posting and categorizing
• TransactRX posting and claim management
• Keeping Unmatched Charges current
• Maintaining Employee statuses within Athena
• Keeping insurance current
• Writing off balances as necessary
• Keeping statement status’ current
• Working Credits
• Patient
• Insurance
• Collections
• Working Collections Reports
• Forwarding Accounts to Outside Agency
• CPS Tasks
• Posting Remits
• Posting No-Pays
• Working Credits
• Patient
• Insurance
• Working Balances
• Patient
• Moving to collections status
• Forwarding Accounts to Outside Agency
• Insurance
• Misc projects as identified
• Moving money that is in deposit onto an account so it can be identified.

Equipment Operated : Standard office equipment such as phone, computer, printers, copiers, and fax machines.

Work Environment : Position is primarily in a well-lit office environment.

Mental / Physical Requirements : While performing the duties of this job, the employee is regularly required to talk or listen.

The employee is primarily sitting at a desk utilizing a computer and phones.

DISCLAIMER

The above information is intended to describe the general nature and level of work being performed by people assigned to this job.

It is not intended to be an exhaustive list of responsibilities, duties and skills required of personnel so classified. Examples listed do not preclude the performance of other duties similar in nature or in level of complexity.