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Medical Billing and Collections Specialist

FYZICAL Therapy & Balance Centers

Medical Billing and Collections Specialist

Granger, IN
Full Time
Paid
  • Responsibilities

    JOB SPECIFICATIONS

    FYZICAL Therapy & Balance Centers is seeking a Billing and Collection Specialist. The Billing and Collection Specialist is responsible for all aspects of the billing process, from verifying and submitting the original claim to tracking and reconciling payments. This position manages the billing and follow-up of all third-party medical claims. This position is responsible for the reconciliation of the account receivable report and forwarding of unsettled accounts to the collection agency.

    Principle Duties and Responsibilities:

    Promotes the mission and philosophy of providing quality healthcare and related services to the medically under-served. Upholds and ensures compliance with and attention to all corporate policies and procedures, as well as the mission and values of the organization.

    Ensures all actions, job performance, personal conduct, and communications represent the organization in a highly professional manner at all times.

    Reviews all encounters to ensure complete documentation and accurate coding.

    Prepares accurate claims for timely submission to the appropriate third-party payers (whether electronic or paper-based).

    Posts third party payments received to appropriate patient accounts; files Explanation of Benefits (EOBs) according to clinic procedure.

    Monitors, reviews, and tracks all correspondence from insurers regarding claims.

    Works cooperatively with third-party payers to reconcile payments in a timely manner.

    Investigates all denied claims, corrects any errors and resubmits the claims for payment.

    Ensures that FYZICAL staff complies with various third-party rules and regulations, highlighting issues when common errors or patterns arise.

    Prints monthly reports regarding third party claims. Investigates all third-party claims that become 60 days past due to determine the cause. Distributes overdue/denied claims and reports to administrative leadership.

    Monitors the status of unpaid claims and generates reports for administrative leadership.

    Updates patient insurance information on a regular basis, double-checks on current coverage. Rebills for previous visits if covered.

    Manages all aspects of the prior approval/authorization process.

    Handle and submit payment for monthly clinic bills.

    Prepares and mails statements and letters to patients with unpaid balances.

    Review, settle, and collect for past due accounts receivable report while maintaining a positive relationship with our clients. Print our A.R. report routinely for progress reference.

    Forwarding past due accounts to collection agency per company protocol.

    Process medical record requests.

    Performs other duties as assigned.

    Knowledge & Skills

    Requires knowledge of and ability to work with a multitude of insurance companies.

    Requires ability to handle diverse work functions and multi-task projects with a variety of billing and insurance issues.

    Requires strong math and accounting skills and analytical ability to properly make calculations, balance records, prepare reports, and apply computer concepts to billing practices.

    Demonstrates specific knowledge of various third-party payor practices and procedures and CPT and ICD-10 coding in order to ensure that billings are accurately completed and in the proper format for efficient processing and payment.

    Demonstrates well developed interpersonal and communication skills, both oral and written, necessary to effectively deal with a diverse group of people and compose written communications using correct spelling, grammar, and format.

    Requires knowledge of revenue cycle, computers, data entry, and spreadsheet software.

    Education and Experience

    High School diploma required

    Bachelor’s degree preferred

    1-year experience of medical billing in a health care environment is required.

    Knowledge of ICD-10 and CPT coding principles and experience using medical billing software is preferred.

    Proficiency in Microsoft Excel required.