Department Function: Provides accurate billing and collection of all medical and dental procedures. Receive payments for all procedures and resolve billing/coding errors in a timely manner.
Summary of position: Under the supervision of the Accounting Manager, submit claims to collect payments for all procedures performed. Responsible for billing and collecting Medicare & Medicaid reimbursements, resolving discrepancies, adjusting claims, preparing reports; office and customer coordination. Act as the patient billing expert for front-office personnel.
· Review, Edit and Process Medical and Dental claims, as assigned in timely manner.
· Review, Edit and Process claims on hold.
· Review and correct rejections and denials.
· Review, correct and print dental patient statements for mailing.
· Reconcile patient account posting
· Answer communications (phone, mail and email) regarding any billing or claims-related concerns.
· Assist in implementing the day-to-day functions of the Billing department, standardizing the methods in which work will be accomplished.
· Prepare reports for and participate in Revenue Cycle Management (RCM) weekly meetings.
· Orient the staff and patients to billing policies and procedures.
· Reviewing front office billing or coding errors with front office supervisor.
· Count and record cash collected and prepare cash deposit.
· Travel to multiple clinic sites to collect fees.
· Reconcile batches and take deposits to bank.
· Follow cash handling policies and procedures.
· Maintain appropriate documentation and up-to-date records.
· Attend staff and educational meetings regarding billing, planning and implementation.
· Acts as lead in resolving patient billing issues, questions and concerns.
· Post and review payments received to appropriate patient's account.
· Assist in balancing accounts receivable, reconciling statements as needed.
· Assist with the implementation of a new billing system (if/when needed).
· Assist in preparing financial and statistical reports as directed
· Develop and utilize computer reports and output.
· Monitor and collect accounts receivables.
· Data entry for all patient charges and refunds.
· Responsible for computer billing, mailing, recording and collection.
· Data entry on all Medicare Part A&B billing charges and supplies.
· Maintain billing and payment log and complete all crossover billing as necessary or directed.
· Responsible for completing all Medicare billing forms and back-up information required.
· Keeping in contact with the responsible parties involved as to payments due and the status of their accounts.
· Perform additional duties, as assigned.
- Billing experience required; Coding certification preferred
- Some college experience. Bachelor’s degree preferred.
- Experience with FQHC billing, a plus
- Bilingual, a plus
- Highly organized, self-starter
- Attention to details, data entry, knowledge of EOB, and documentation skills
- Patience to perform daily functions
- Customer service skills
- good work ethic - team player
Physical Requirements and Working Environment:
- Frequently work in a seated position at a desk, frequent walking.
- Respond and react immediately to verbal instructions/requests and to auditory signals from equipment and personnel.
- Physically close and distance visual activities involving objects, persons, and paperwork, as well as discriminate depth and color perception.
- Perform mathematical calculations for billing transactions and administration.
- Communicate effectively, both orally and in writing, using appropriate grammar, vocabulary, word usage, and interpersonal skills.
- Typing and computer skills needed to process and submit claims online, and to communicate with personnel.
- Knowledge of medical terminology
- Knowledge of billing and coding terminology
- Experience with general office software (Microsoft Word, Excel, Adobe Acrobat)
- Experience with EHR software (Athena and Dentrix Ascend preferred)
Skills and Abilities:
- Maintain Good Work Habits:
- Function within the scope of billing and coding practices
- Accept constructive criticism with a positive attitude
- Regular and punctual attendance
- Show initiative and responsibility
- Exercise efficient time management
- Organize and multi task
- Patient relationships
- Approach patients in a professional manner
- Adapt communications to individual’s ability to understand
- Maintain confidentiality (HIPAA guidelines)
- Staff relationships
- Work as a team member
- Show leadership
- Follow established policies and procedures
- Communicate effectively verbally and in writing
- Use medical terminology appropriately
- Provide services in courteous and pleasant manner
- Ability to maintain confidentiality
- Maintain personal grooming appropriate to the health care profession