Neighborhood Family Practice
Position Title: Billing Specialist (Medical/Dental)
1. Position Summary: Responsible for billing activities including posting charges, payments and adjustments to patient accounts. Responsible for timely collection of amounts due from patients and insurance carriers. Liaison between Neighborhood Family Practice and patients/insurance carriers regarding billing issues and inquiries. Reports to Billing Supervisor.
2. Essential duties and responsibilities which must be performed in order to carry out the position purpose summarized above:
(The following description is a general representation of the key duties and responsibilities of this position. Other duties may be assigned, as required.)
A. Submit claims on a regular schedule, typically daily, to insurance carriers to ensure prompt processing and payment.
B. Follow-up on unpaid claims and resolve any billing issues. This process includes timely review of workqueues, as assigned by the Billing Supervisor.
C. Identify and resolve patient billing questions and issues.
D. Post all charges, payments and adjustments in a timely manner.
E. Ensure appropriate application of CPT and ICD codes. Identify coding issues and bring to the attention of the appropriate provider. Identify education needs for providers based on coding assessments.
F. Review accounts for possible assignment to collection agency and make recommendations to the Billing Supervisor.
G. Maintain information in a confidential manner.
H. Identify accounts that may need a refund.
I. Participate in educational activities.
A. Specific knowledge, training or skills required to perform the duties of this position.
Specific concepts, courses, training programs or required certifications:
(To perform this position successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skills and abilities required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
- Familiarity with governmental (Medicare and Medicaid) and health care fiscal regulations, billing and reporting.
- Possess analytical and problem solving skills.
- Possess strong math skills.
- Fluency in English; fluency in Spanish preferred.
- Computer proficiency: related billing software and Microsoft Office Suite.
- High school diploma or GED.
B. Essential Physical Demands and Working Environment:
(The physical demands and work environment described below are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
- Ability to see, communicate, hear and utilize electronic communication devices.
- Office work environment.
- Limited local and overnight travel.
C. Previous experience that is necessary background to qualify for this position:
- Minimum of one year of physician billing experience with specific knowledge in medical terminology and CPT/ICD coding.
REPORTS TO AND EVALUATED BY: Billing Supervisor
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