Billing Specialist

DESCRIPTIVE SUMMARY

The Dermatology Billing Specialist plays a crucial role in the financial operations of a dermatology practice by managing billing processes, ensuring accurate reimbursement, and maintaining compliance with insurance policies and regulations.

ESSENTIAL FUNCTIONS

• Accurately assign appropriate medical codes (CPT, ICD-10, HCPCS) to dermatological procedures and services for billing purposes.
  
• Prepare and submit insurance claims for reimbursement, ensuring all required documentation is complete and accurate.
  
• Monitor and track payments, denials, and outstanding balances, taking necessary actions to ensure timely payment and minimize revenue loss.
  
• Respond to patient inquiries regarding billing statements, insurance coverage, and payment options, providing clear and accurate information and assistance as needed.
  
• Stay updated on changes in insurance regulations, coding guidelines, and billing practices to ensure compliance and prevent potential issues or penalties.
  
• Work closely with healthcare providers, administrative staff, and insurance companies to resolve billing issues, address concerns, and optimize revenue cycle processes.
• Work with reception staff, ensure appropriate collection of co-pays, spend down and self-pay fees.
• Posts adjustments, transfer of responsibility and refunds, as necessary.
• Maintains strictest confidentiality; adheres to all HIPAA guidelines/regulations.
• Other duties as assigned.

COMPETENCIES

• Problem Solving/Analysis.
• Customer/Client Focus.
• Results Driven.
• Ethical Conduct.
• Thoroughness.

POSITION REQUIREMENTS (REQUIRED & PREFERRED)

• Previous medical billing experience including knowledge of billing related reporting; 3 - 5 years’ experience in health-care billing & collection practices.
• Working knowledge of insurance - HMO, PPO, EPO, Medicare, Indemnity, and Out-of-Network.
• Excellent customer service and communication skills along with good math skills, ability to read, understand and follow verbal or written instructions.
• Ability to navigate Health Plan websites.
• Working knowledge of computerized registration, billing, and collection procedures.
• Familiarity with ICD-10 and CPT coding.
• Strong interpersonal skills.
• High attention to detail and ability to multi-task.
• Working knowledge of medical billing systems, particularly EMA.
• Good phone etiquette.

PHYSICAL DEMANDS AND WORK ENVIRONMENT:

The physical demands and work environment characteristics described here are the representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions:

• Physical demands: While performing the duties of this job, the employee is required to walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; balance; eye-hand coordinator; handling and lifting patients; stoop; talk or hear. The employee must occasionally lift/or move up to 20 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception, and the ability to adjust focus.
• Work environment: General office setting. Well-lighted and well ventilated. Constant contact with individuals from any backgrounds; minimum exposure to communicable diseases. Noise level in the work environment is usually moderate.