Billing Specialist

Job Type Full-time Description

GAP is the longest established gastroenterology practice in the Piedmont Triad area. This independent, physician-owned GI practice is looking for a Billing Specialist. GAP evaluates new patients, performs consultations and conducts follow-up visits for chronic gastrointestinal conditions. Our offices draw and assess labs, administer injections and monitor medication therapies. We offer on-site infusion services and our clinical staff assist with a variety of in-office procedures. When appropriate, GAP schedules appointments for outpatient screening, diagnostic and/or treatment procedures. Our endoscopy centers are physician-owned outpatient ambulatory surgical centers which specialize in colon cancer screening and prevention as well as a number of other procedures including endoscopy, and Interstim Bowel Control Therapy..

Excellent benefits package include health insurance options, dental, vision, life, long-term and short-term insurance coverage and a robust 401k/profit sharing plan; voluntary benefits including voluntary life and medical bridge plans. Paid time off, paid holidays and a friendly environment where work/life balance is a priority. Exceptional providers and well-trained staff on board. Looking for another strong team member!

Responsibilities include various aspects of the revenue cycle. This may include but is not limited to resolving insurance denials or no response claims issues, payment posting (insurance or personal), patient collection activities including referral of accounts to collections agency, reviewing patient and insurance credits to determine if a refund is applicable, answer incoming phone calls into the billing office from patients, insurance companies and internal staff.

Hours: Full time (Monday – Friday, 8am – 5pm)

Hybrid work opportunity possible after training and orientation period at the discretion of management. Team member must come to office one day a week.

Requirements

Insurance Follow-up

If assigned,

• Utilize coding and billing knowledge to review and resolve insurance denials from various insurance companies. This includes making contact with insurance companies via their online portal or via the telephone to identify the reason for the denial.
• Initiating and then tracking appeals with insurance companies as needed.
• Follow up on claims that have had no response from insurance.
• Follow up on claims that have had partial payments but have remaining charges that are unpaid.
• Assist with the resolution of claim edits within EPIC and claim edits received from the Clearinghouse.
• Document all follow-up activities within the EPIC system.

Payment Posting

If assigned,

• Accurately post insurance payments both electronically and manually within the EPIC system. This will be done in conjunction with remittance information that is received through the Clearinghouse or individual payer websites.
• Review and resolve any insurance credits or recoupments as noted on electronic remits and paper EOBs.
• Accurately post patient payments.

Patient Collections

If assigned,

• Review accounts that are at least 120 days old as a patient balance to determine if it is appropriate for the patient to receive a final notice letter.
• Generate Final Notice letters out of EPIC for patients as deemed appropriate
• Assist with final review of accounts that have received a final notice letter and refer accounts to an outside collection agency following defined patient collection procedures.

Patient and Insurance Refunds

If assigned,

• Review patient accounts in the credit WQs that have a credit balance and no outstanding charges to determine if a refund is due.
• Request patient refunds as deemed appropriate
• Review insurance refund requests as received and determine if the request is valid. If request is valid, make the necessary adjustments on the patient account to create the requested refund amount and correct the account with any new insurance information and/or refile a corrected claim. If request is not valid, perform necessary follow-up with the insurance company.

Customer Service

• Answer incoming billing calls from patients and process credit card payments made over phone.
• Serve as a resource to other GAP staff to help answer insurance and billing related questions.
• Ensure the privacy and confidentiality of patient information.
• Use customer service principles and techniques to deal with patients calmly and pleasantly.

Physical Requirements: Must possess the physical and mental abilities to perform the tasks normally associated with a Coding and Billing Specialist that are mostly sedentary with some standing, walking, reaching. Daily and repetitive data entry may cause nerve problems unless ergonomic techniques are used. Periodic stress occurs from handling many calls and dealing with patient requests. While performing the duties of this job, the employee is regularly required to talk and hear. Stress can be triggered by workload and difficult patients.

GAP is an equal opportunity employer.