Billing Support Specialist - Call Representative

Ortho Rhode Island is a world-class group of talented providers and professionals, all working together to offer value and quality in everything we do. Each Ortho Rhode Island team member is dedicated to thinking like a patient, and to offering the best experience in our industry, driven by our core values: delivering on our word, respecting each other, innovating in orthopedics, valuing every individual, and engaging our community.

The Patient Call Representative is responsible for receiving a high volume of inbound patient calls related to patient balances, statements, and related inquires. The Patient Call Representative is expected to provide relevant information and resolve the call with a polite and professional approach. The position supports the company’s overall Operations and Client Services by efficiently and effectively providing account data needed for the Revenue Cycle process and delivering results.

Essential Functions:

Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• Answering calls in a courteous and friendly manner
• Accurately documents patient accounts of all actions taken.
• Understand payment posting to explain balances to patients.
• Process patient payments through our credit card vendor
• Pull eobs if patient disagrees with how claim was posted.
• Research copayments through Health Ipass that were not posted in the system.
• Move money from ticket to ticket/accounts.
• Distributing electronic faxes throughout the billing department.
• Coordinate communication between departments and/or locations according to specific criteria to obtain a satisfactory resolution
• Achieve goals as established by ORI.
• Establishes and maintains a professional relationship with all ORI staff to resolve problems and increase knowledge of account management.
• Actively participates in department meetings.
• Completes additional projects and duties as assigned.
• Ability to successfully track and follow up on information requests to and from clients.
• Work with clients and groups to facilitate information and resolve charge questions
• Professionally responds to all billing-related inquiries from patients, staff, and payors in a timely manner
• Other duties as assigned

Performance Requirements:

Knowledge:

• Knowledge of CPT, ICD10 and HCPCS codes
• Maintain knowledge and follow HIPAA regulations.
• Knowledge of medical accounts receivable practices and business office procedures.
• Knowledge of coding and clinic operating policies and procedures.
• Knowledge of insurance agency reimbursement procedures and practices.
• Knowledge of Microsoft Word, Excel, and Outlook.

Skills:

• Strong customer service skills; answering client calls; prompt return and follow up to all interactions; prompt response to requests for information, both internally and externally

• Ability to use email, search engine, Internet; ability to effectively use payer websites.

Abilities:

• Ability to multi-task.
• Ability to read, understand and follow oral and written instruction.
• Ability to communicate tactfully and effectively with patients, employees, and providers.
• Ability to run standard office equipment.

Work Environment:

This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines.

Physical Demands:

• Requires mobility, frequent walking, standing, and sitting, some bending, stooping, and stretching and periodic lifting of up to 25 lbs.
• Requires coordination and manual dexterity sufficient to operate office equipment
• Requires normal (corrected) vision and hearing

Position Type and Expected Hours of Work:
This is a full-time position. Days and hours of work are typically Monday through Friday.

Travel:
No overnight travel is expected for this position. There may be occasional local day travel to Company Divisions.

Required Education and Experience

1. High School Diploma or equivalent
2. Two years medical collection experience, preferably orthopedic practice.
3. Two years of medical insurance background.
4. EMR experience
5. Preferred experience with various billing systems, such as GE Centricity CPS, Intergy and Caretracker.

Ortho RI is an equal opportunity employer committed to diversity, equity, and inclusion in all aspects of the recruiting and employment process.