GENERAL OVERVIEW

Responsible for accurately and efficiently managing patient accounts, ensuring timely billing and collections, and providing exceptional customer service. Strong understanding of insurance processes, billing regulations, and excellent communication skills.

ESSENTIAL RESPONSIBILITIES

Patient Account Management:

• Work with insurance companies, patients, and other staff to follow-up on accounts until zero balance, turned over for collection, or refund requested.
• Create and maintain accurate electronic patient accounts.
• Verify patient insurance eligibility and benefits.
• Process patient charges and payments, including co-pays, deductibles, and co-insurance.
• Post payments and adjustments to patient accounts.
• Research and resolve patient billing inquiries, discrepancies, and missing information.
• Generate and mail patient statements.
• Manage patient payment plans and collections.
• Work with staff and physicians to resolve coding and error issues and ensure accurate and timely billing.

Insurance Processing:

• Submit electronic claims to insurance companies.
• Monitor claim status and follow up on rejected or unpaid claims.
• Appeal denied claims and provide necessary documentation.
• Research and resolve insurance payment discrepancies.
• Stay up-to-date on insurance regulations and changes.

Customer Service:

• Provide excellent customer service to patients, answering questions and resolving concerns in a professional and courteous manner.
• Explain billing policies and procedures to patients.
• Assist patients with payment arrangements and financial assistance options.

Other Duties:

• Maintain required billing records, reports, and files.
• Drive to bank and post office daily to make deposits and pick up mail, and batch it up to post.
• Assist with other duties as assigned.

QUALIFICATIONS

• High School diploma or GED.
• Minimum of 1 year experience in medical billing and collections.
• Knowledge of medical terminology, ICD-10 and CPT coding.
• Proficiency in using electronic medical records (EMR) systems.
• Minimum 40 WPM typing speed.
• Strong understanding of insurance processes and procedures, including Medicare, Medicaid, and commercial insurance.
• Ability to work independently and as part of a team.
• Detail-oriented and organized.  
• Valid driver’s license is required, as is use of personal vehicle (mileage reimbursed). 

PHYSICAL/MENTAL DEMANDS: Ability to look at computer screen for long periods of time. Vision must be corrected to 20/20 and hearing must be in normal range. Work requires hand dexterity for using a calculator or computer keyboard, mobility to complete errands or deliveries, and sitting for extended periods of time. Driving a vehicle is required. 

WORK ENVIRONMENT: This job operates in a medical office environment. This role routinely uses standard office equipment such as computers and phones.