We are looking for a motivated performer to join our Business Office team as a Biller/Collections Specialist. We are looking for a top performer with previous experience and knowledge of billing, reimbursement, and payment posting. This is a fast paced environment committed to producing the highest quality work for our surgery centers. The ideal candidate will be a hard working, motivated individual who is personable and courteous. We are looking for a competent Biller to perform billing and payment data entry on outpatient surgery claims. The Biller is responsible for performing all billing and payment posting related duties on patient accounts. This position is expected to be knowledgeable of the specific provisions in the managed care contracts as they relate to billing/reimbursement. Individual shall be knowledgeable of the most current coding guidelines and carrier reimbursement policies.

Performs a variety of Medical Records duties such as chart analysis, billing, audits, and data entry. Key patient, insurance, and all other types of payments into the patient accounting system. Review and verify allowable per EOBs and adjust accordingly per insurance contracts. Month end cash balancing. Adjudicating secondary/tertiary claims. Identify patient and insurance refund situations and set up for reimbursement, if applicable.

The Biller/Collections Specialist, must have extensive knowledge of claims reimbursement and collection efforts for Managed Care, Medicare, Medicaid, Workers Comp, Commercial plans, etc. We are looking for a top performer with an extensive knowledge of billing, collections and reimbursement of claims processing. This team member is responsible for follow up on delinquent surgery center claims), working an expected number of claims per day. Knowledge of how to interpret a managed care contract, Medicare and Medicaid and Workers Compensation claims is a must. You will be given tools to calculate allowable and required to determine appropriateness of reimbursement and appeal claims as necessary.

Extensive contact with insurance carriers of all types, as well as communication with patients regarding out of pocket amounts is required. Identification of accounts that have been either under or over paid, issuing credit balance information either to the insurance carrier or the patient. All of these practices done in a professional and communicative manner, per policies and procedures, guidelines, internal control measures and established goals. .

Candidate must be a team player, and have ability to communicate well with direct reports, patients, customers, insurance carriers, etc. Ability to manage accounts worked independently, and in a productive manner. Projects a professional demeanor and appearance while maintaining the confidentiality of administration, patients, physicians and employees. Works under stress and in situations that demand patience and tact while providing impeccable service.

This is a fast paced environment committed to producing the highest quality work for our surgery center. An ideal candidate will be personable and courteous.

Required Skills

Requirements Qualification Requirements:

• High School Diploma or equivalent.
• Excellent communication skills using proper English grammar.
• Minimum 2 years of billing experience.
• Familiar with patient accounting software, especially AdvantX.
• Ability to read and understand insurance explanations of benefits and managed care contracts
• Knowledge of Internet Explorer, Microsoft Excel, Microsoft Word, and Outlook.

Required Experience

• 2 - 3 years previous billing and collections experience, with emphasis on healthcare insurance billing of all types. Preference shown to previous experience in an ambulatory surgical setting.

•  Prefer previous experience working with Advantx. (Patient Accounting System) Ability to work independently.

• Medical terminology.

• Excellent communication skills and interpersonal skills.

• Skilled in time management and prioritization of workload.

• Outstanding customer service skills; always demonstrates professionalism.

• Confident utilizing critical thinking skills.

• Typing 45-60 WPM. High School Diploma or equivalency.

• Some college coursework preferred.

• Proficient with Microsoft Office products.

• Experience with electronic patient information systems.