Job Description
Job DescriptionSalary:
JOB DESCRIPTION: The job of the billing specialist is to post pending charges, work insurance denials, and process claims for insurance billing.
PRINCIPAL DUTIES AND RESPONSIBILITIES:
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Duties and Responsibilities of the Billing Department:
- Post pending charges.
- Benefit verification.
- Checking other offices charges.
- Processing insurance claims.
- Working Prior Authorizations
- Initiate and follow up on authorizations and pre-determinations with applicable insurance in a timely manner.
- Follow up on status
- Working on paper denials.
- Working electronic denials.
- Working with insurance companies.
- Working with collection accounts.
- Verifying a diagnoses with a procedure.
- Keep journal of all daily money activity and balance out every night.
- Make sure every procedure for every patient seen are posted.
- Work the denials and find out why the insurance company has not paid and what we need to do for processing that claim.
- Work Aging Reports for insurance companies and patients.
- Posting insurance payments to the correct account.
- Work the Claims Tracker.
- May be required to help with the electronic billing.
- Supply collection companies with information that they might need.
- Call insurance companies and check the status of claims.
- Help to answer phone calls.
- Answer patient questions about their bills.
QUALIFICATIONS:
- Must have at least a High School Diploma or G.E.D.
- Working knowledge of how a Medical office runs.
- At least one year of experience working in the billing field would be preferred but not required.
- Knowledge of prior authorization preferred.
- Have knowledge of the internet and how to use it to check address and find new address.
- CPR Certified Preferred.
- Experience working with electronic payment systems.
COMPETENCIES
- Financial Management.
- Technical Capacity.
- Performance Management.
- Ethical Conduct.
- Communication Proficiency.
- Personal Effectiveness, Credibility.
- Knowledge of Microsoft Office.
SUPERVISORY RESPONSIBILITY
None
PHYSICAL DEMANDS:
Physical demands described are representative of those that must be routinely met by and employee to successfully perform the essential duties of this position. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform the essentials duties.
Ability to lift minimum 15 pounds.
Ability to perform job responsibilities in a facility with multiple levels and without elevator or mechanical transportation.
Operates a computer and keyboard.
POSITION TYPE/EXPECTED HOURS OF WORK:
This is a full-time position, and core hours and workdays are Monday through Friday, 8:00 am to 4:30pm. This position may require evening or weekend work.
WORK ENVIRONMENT:
This job operates in a professional office environment. The work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Reasonable accommodations may be made to enable qualified individuals with disabilities to perform essential duties. The work environment is smoke-free. While performing the duties of this job, the employee is not normally exposed to weather conditions. The noise level in the work environment is usually low to moderate.
EEO STATEMENT
OVP Health Care provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability or genetics. In addition to federal law requirements, OVP Health Care complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfers, leaves of absence, compensation and training.
OVP Health Care expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper inference with the ability of OVP Health Care employees to perform their job duties may result in discipline up to and including discharge.