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Business Office Specialist

Surgery Center of Munster LLC
Munster, IN
  • Posted: over a month ago
  • Full-Time
Job Description

JOB SUMMARY

Ensures accuracy of data entry of daily charges to include implants as well generates electronic
and paper insurance claims, patient statements and performs collection of
outstanding insurance or patient balances.

Reports To: Business Office Manager

Supervises: None

Classification:
Non-Exempt

QUALIFICATIONS

High School Diploma preferred.

Minimum two years experience in medical billing preferred.

Knowledge of medical billing/collection practices preferred.

Experience in a surgical facility preferred.

Proficient in MS Office applications which include Outlook, Word, Excel and PowerPoint.

OCCUPATIONAL EXPOSURE

Office Environment

RESPONSIBILITIES:

Scheduling:

1. Considers priorities and special needs when scheduling preoperative appointments and
surgical procedures.

2. Schedules appointments and procedures according to policies on nursing and anesthesia
staff availability, patient needs and physician’s block time.

3. Coordinates surgical preoperative appointment schedule with clinical preoperative
activates.

4. Maintains schedule according to procedure and physician’s time and staffing requirements.

5. Coordinates schedule assessing time and equipment availability; identifies conflicts and
adjusts schedule as needed.

6. Prepares appointment schedule and Surgery Schedule for review by the Operating Room
Supervisor so that adjustments may be made as required.

7. Assumes clerical duties and responsibilities as necessary.

8. May open and distribute mail according to Facility policy.

9. May prepare bank deposits following Facility cash controls.

10. Coordinates obtaining diagnostic tests and places diagnostic test reports in appropriate section of patient medical record.

11. May perform duties of the admitting Receptionist and/or Biller as needed.

Insurance Verifications/Pre-Certification Responsibilities

12. Act as liaison between patient, physician office, and insurance company to assist
patients with regards to financial responsibility.

13. Notify all scheduled patients of their financial responsibility prior to their date of service.

14. Verify patient insurance eligibility and benefits using technology tools, the telephone and the internet to ensure compliance with the facilities policies and procedures.

15. Coordinate with insurance providers and the physician office to obtain pre-authorizations. Document the authorizations in the system patient accounts.

16. Obtain information for medical necessity determination and coordinate with the
physician office if additional information is needed.

17. Communicate with patients to obtain any missing information necessary to achieve financial
clearance.

18. Perform Benefit verifications on all new patients.

19. Obtains and verifies patient demographic and financial information

Billing:

20. Monitors receipt of daily coding and performs charge entry ensuring accuracy of charges entered, modifier usage, implant coding and timeliness of filing insurance claims both on paper and electronic.

21. Monitor and addresses all electronic scrubbing errors to ensure claims get to the payer timely.

22. Initiates follow-up phone calls on accounts with an outstanding balance.

23. Maintains standards to ensure systematic, consistent and timely collection follow-up.

24. Initiates follow-up on accounts with outstanding balances that do not have appropriate payment arrangements.

25. Works the Aged Trial Balance report daily and ensures every outstanding account is worked a minimum of every 30 days.

26. All notes regarding written and/or verbal communication on the account will be maintained in the comment file on the patient’s account and should include at a minimum the following:

A. Date of collection work

B. Telephone number of contact

C. Full name of contact

D. Location of contact (home, work, employer, insurance co.)

E. Complete summary of conversation to include check number and date of payment promise.

F. Next follow-up date based on payment promises.

27. Works patient due accounts placing the initial follow-up call 14 days following the date of service. Subsequent follow-up calls should be made every 14 days until the balance is paid or until adequate payment arrangements are made according to policy.

28. Makes recommendation to BOM for accounts aged 60 to 120 days without appropriate payment arrangements be sent to a collection agency.

Medical Records Responsibilities

29. Check each medical record for completeness, marking and attaching a deficiency slip as needed.

30. Performs release of information functions as necessary, per facility policy, state and federal regulations, and HIPAA guidelines.

31. Maintain a log of record requests received, processed, and mailed out.

32. Assist Medical Staff with completion of medical records.

PHYSICAL DEMANDS:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

  • While performing the duties of this job the employee is frequently required to sit, converse, and listen; use hands to touch, handle, or feel objects, tools or controls; and to reach with hands and arms. Specific vision abilities required by this job include close vision and the ability to adjust focus.
  • The employee must be able to lift and/or carry over 20 pounds on a regular basis and be able to
    push/pull over 25 pounds on a regular basis.
  • The employee must be able to stand and/or walk at least five hours per day.

WORK ENVIRONMENT:

· The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Surgery Center of Munster LLC

Address

Munster, IN
46321 USA

Industry

Business

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