Billing/Collections Specialist

Ortho Texas
75010, TX, US
Full-time

Job Description

Job Description

Description :

Job Summary : Responsible for submitting claims, appeals, and following up on outstanding balances from the patients insurance.

Responsible for solving all claim denials.

Essential Duties and Responsibilities : The essential duties of the position include the following. Other duties may be assigned.

Key Functions :

  • Prepares and submit clean claims to various insurance companies either electronically or on paper.
  • Contact carriers by phone or website for claim status on outstanding insurance balances.
  • Process and work all insurance correspondence.
  • Perform various collection actions including contacting patients by phone, correct and resubmitting claims to other carriers.
  • Obtain necessary documentation required to submit to insurance to expedite payments.
  • Answers questions from patients, clerical staff and insurance companies.
  • Identify and resolve patient billing complaints.
  • Prepare appeal letters for all claims that are denied for payment.
  • Document all collection activities using guidelines in place.
  • Identify underpayments by checking payments received against our contracted fee schedule.
  • Work and process all insurance refund requests.
  • Report payer issues or delays to supervisor.
  • Participate in educational activities
  • Maintains strict confidentiality; adhere to all HIPAA guidelines / regulations.
  • Team Player with ability to solve problems and recommend solutions.
  • Must be able to manage assigned workload and prioritize accordingly.
  • Maintain accurate and timely reconciliation of accounts receivable.
  • Review claims stopped in the claim scrubber.
  • Work Claims rejected by the clearinghouse.

Requirements :

Qualifications : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.

The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education / Experience : High School Diploma or GED, and minimum one year experience in a medical billing / collections field.

26 days ago
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