Position Summary:
Responsible for billing and processing insurance payments; investigating needed information regarding denied claims with timely follow-up with insurance payers; interpreting the patient account regarding billed codes and chart documentation; communicating with patients and/or guarantors about outstanding balances by phone or mail to collect balances; establishing and monitoring payment plans; documenting all follow-up with insurance payors and patients in the billing software.
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High School Diploma or GED
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At least three (3) years of medical insurance billing and coding experience
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Basic understanding of medical ICD 10 and CPT medical billing codes
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Knowledge or experience with Wound Care and Hyperbaric Therapy, preferred
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Proficient use of computers, Microsoft Office, and common office equipment
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Good verbal and written communication skills
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Detailed oriented and ability to prioritize work assignments; able to work independently
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Familiarity with HIPAA privacy requirements regarding patient information
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Responsible for billing and processing insurance payments; investigating needed information regarding denied claims with timely follow-up with insurance payers; interpreting the patient account regarding billed codes and chart documentation; communicating with patients and/or guarantors about outstanding balances by phone or mail to collect balances; establishing and monitoring payment plans; documenting all follow-up with insurance payors and patients in the billing software
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Reviews assigned patient schedules to ensure information for insurance claims to include patient demographics, insurance information, diagnosis and treatment codes/modifiers and provider information is complete and accurate
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Submits insurance claims through billing software's clearinghouse vendor
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Follows up with insurance payer on unpaid, underpaid or rejected claims
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Reviews Denial Report daily; responds to non-payment reason codes; refile claims as needed
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Checks for maximum reimbursement for services and providers
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Prepares appeal letters needed to support any unpaid claims with needed documentation
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Ensure that secondary claims have been submitted for patients with more than one insurance
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May assist with re-verification of patient benefits, eligibility and coverage as needed
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Determines patient responsible co-pays, deductibles, and co-insurance
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Prepares a weekly Patient Balance Log for the Clinic Front Desk to use to collect patient responsible balance
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Establishes payment plans for past due balances; monitors collections; documents payment plan in the billing software
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Performs 'soft collections' for patient past due accounts to include a letter and/or phone call
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May assist with posting patient payments
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Assist with reviews and audits as needed or assigned
Minimum Qualifications:
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High School Diploma or GED.
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At least three (3) years of medical insurance billing and coding experience.
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Basic understanding of medical ICD 10 and CPT medical billing codes.
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Knowledge or experience with Podiatry, Wound Care
Essential Responsibilities:
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Proficient use of computers, Microsoft Office, and common office equipment.
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Good verbal and written communication skills.
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Detailed oriented and ability to prioritize work assignments; able to work independently.
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Familiarity with HIPAA privacy requirements regarding patient information.