Job Title: Medical Insurance Billing Specialist
FLSA Status: Exempt
Reports To: Medical Insurance Contracting, Credentialing and Billing Manager
JOB SUMMARY: Under the supervision of the Medical Insurance Contracting, Credentialling and Billing Manager, the Billing Specialist will be responsible for day-to-day support of medical insurance billing for DME and clinical services.
Essential Duties and Responsibilities include the following as well as other duties and responsibilities that may be assigned:
- Demonstrates proficiency in third party filing of claims for medical products and services
- Maintains good working relationships with third party administrators
- Files claims with timeliness and accuracy
- Organized and thorough in tracking outstanding claims
- Maintains working knowledge of current insurance billing practices and requirements of Medicaid and insurance companies relative to claims filing and payment
- Works with clients in procuring information needed for processing claims
- Follows HIPAA policies and MilkWorks policies in handling of sensitive client information
- Works with Insurance Contracting, Credentialing and Billing Manager in recording of payments
- received and direct billing of fees assigned to patients
- Works with Insurance Contracting, Credentialing and Billing Manager on management of overdue balances; escalates matters correctly and with appropriate urgency
- Keeps detailed and accurate records on all billing and corresponding payments received.
- Notifies supervisor of any changes in third party billing practices that directly impact the organization.
- Respond to voicemails, phone, and emails promptly, typically within one business day
- Other duties as assigned
- Maintain/copy/replace all billing forms and paperwork
- Performs all duties and responsibilities in a customer service, efficient, team-oriented manner
- Establishes and maintains effective channels of communication and a professional relationship with patients, clinical staff, co-workers, contractors, and outside facilities
- Uses office equipment and materials in a safe and acceptable manner, follows established safety procedures, uses appropriate safeguards, and observes common sense rules of safety in all on-the job activities
- Conducts self in manner reflecting on the core values of the company, and encourages others to do the same
- Observes strict patient confidentiality in dealing with patients and patient information
- Work from the assigned location with reliable and predictable attendance
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Minimum of 1-2 years of relevant experience with DME and medical insurance billing
- Associates Degree, medical billing and coding certification or equivalent experience required
- Proficient understanding of billing software and electronic medical records required; experience with AMD preferred
- Willingness to actively participate in all aspects of the medical billing process
- Excellent attention to detail with outstanding problem-solving and analytical skills
- Highly organized and self-motivated
- Results driven, persistent, able to self-direct and work independently showing initiative, while seeking guidance when appropriate.
- Ability to multi-task, pay close attention to detail and be flexible in a fast paced and growing organization
- Demonstrated strength in computer software, e.g., MS Office Suite, PowerPoint, and internet-based research
Ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence. Ability to effectively present information in one-on-one and group situations.
Ability to add, subtract, multiply, and divide in all units of measure using whole numbers, common fractions, and decimals
Ability to apply common sense understanding to carry out detailed written or oral instructions. Ability to deal with problems involving a few concrete variables in standardized situations
Other Skills & Abilities:
- Must be proficient in using technology and software applications
- Must be well organized and possess excellent telephone communication skills
- Must be detail oriented, conscientious, and able to follow through
- Medical terminology or training preferred
- Working knowledge of efficient filing systems, office machines and equipment
- Must be able to adjust tasks in accordance with changing deadlines, emergency calls and priorities • Must be able to complete tasks and meet deadlines
- Valid driver’s license and automobile insurance required
Physical Demands: physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- While performing the duties of this job, the employee is regularly required to talk or hear.
- Employee is regularly required to use hands and fingers for typing and filing. The employee is frequently required to reach with hands and arms and occasionally required to stand, walk, stoop, kneel, crouch or crawl
- Employee may lift up to 35lbs; stand and carry items that weigh 10 – 35lbs.
- Specific vision abilities required by this job include close vision, distance vision, peripheral vision, depth perception, and the ability to adjust focus
Work Environment: work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
- Noise level in the work environment is moderate
- Stress level in the work environment is moderate to high
The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.
Must be authorized to work in the United States