Billing Associate

Job Summary

The billing specialist is responsible for coordinating patient and insurance billing for our multi-specialty orthopedic group and providing patient care excellence by performing the following duties:

Principal Duties and Responsibilities

• Responsible for following entire revenue cycle from charge entry through insurance and patient payments.
• Work through an electronic claims worklist to follow up with insurance companies to investigate status of claims. Appeal denials, resubmit claims, send medical records and process any additional information as needed.
• Work in partnership with Athena to ensure claims have processed correctly and payments have been posted correctly.
• Answers telephone, and responds to inquiries from insurance carriers, patients, and co-workers.
• Investigate and resolve billing discrepancies resulting in overpaid/underpaid accounts.
• Establishes payment plans to help patients manage payment of bills.
• Confers with doctors, nurses, and other health personnel to assure complete, current, and accurate medical records.
• Operates computer to process, store, and retrieve health information.    
• Communicate any trends, discrepancies, and underpayments to the Revenue Cycle Manager immediately.
• Submit refunds for processing by the Revenue Cycle Manager.
• Other duties as assigned.

Job Qualifications 

Education 

High school diploma or general education degree (GED).  Two to three years related experience and/or training; or equivalent combination of education and experience a must.

Specific Job Experience

• Ability to maintain the confidentiality and security of sensitive, privileged communications and work product.
• Ability to utilize Electronic Heath Care Record system for documentation to patients’ account/record.
• Knowledge of third-party insurance and billing practices
• Knowledge of ICD-10, CPT, HCPCS codes and documentation guidelines required. 

• Previous medical billing and surgery billing experience required.
• Experience with billing program software, Athena, preferred.  
• Working knowledge of commercial and government insurance
• Coding/Billing Certification Preferred 

Knowledge, Skills and Abilities

• Strong computer skills
• Effective communication skills
• Ability to work independently and as part of a team.
• Prior customer service representative experience required.
• Proficiency in Microsoft Office Applications. (Excel, Outlook, PowerPoint)