Medical Billing Officer

You will take all of the data provided on a patient and use it to submit claims electronically for reimbursement and collect payment for the services provided. Responsibilities include, but not limited to, registering the patient and verifying insurance coverage, collecting the information required to create a claim, knowledge of CPT and ICD-10 coding systems, working directly with the insurance company, healthcare provider, and patient to get a claim processed electronically and paid, knowledge of CMS-1500 & UB-04 billing forms, reviewing and appealing unpaid and denied claims, posting payments and contractual adjustments to patient's accounts, knowledge of third party and CMS Fee schedules, handling collections on unpaid accounts, managing the Accounts Receivable reports, answering patients' billing questions.

DUTIES MAY ALSO INCLUDE BUT ARE NOT LIMITED TO:

Day-to-day billing operations
Charge posting
Posting payments
Being knowledgeable of and adhering to all legal and regulatory requirements concerning appropriate billing
Insurance claim follow-up
Contacting patients about outstanding balances
Front desk coverage
Determining best avenues for claim submission
Appealing denied claims
Insurance verification
Obtaining prior approval/authorization for 2 infusion medications administered on site
Maintaining allowed fee schedules
Patient check-in and check-out
Documenting interaction with payers
Posting payments
Medical billing & medical coding
Retrieving electronic fund transfer admittance advice
Problem solving and addressing issues raised by physicians, employees, and patients, proactively identifying process improvements and system enhancements, engaging in special projects in addition to routine responsibilities
Posting charges daily from the surgical center and from the physicians
Retrieving and processing EFTs from government and commercial payers
Processing paper checks for bank deposits
Providing the highest quality customer care to patients inquiring about their statements
Transmitting claims through a clearinghouse while maintaining low rejection rate
Providing balanced daily transactions Excel spreadsheets

MINIMUM QUALIFICATIONS: BACHELORS DEGREE

Working knowledge of:

Requirements of commercial and government insurance plans
HMO, POS and PPO plans
Basic math and medical practice accounting
HIPAA regulations
Office equipment (i.e. copy machine, fax machine, computers)
Organization policies, procedures, systems, and objectives.
Legal and regulatory requirements
Insurance billing, revenue management, and collections
Basic computer skills, including proficient use of the Microsoft Office Suite of products
A/R management
Deductibles and co-pays
CPT and ICD coding as applied in physician practices for billing and clinical purposes
Medical billing procedures and medical insurance

PREFERRED EXPERIENCE

Experience in or exposure to the field of PRIMARY CARE & URGENT CARE CENTERS.
Strong financial background with previous experience in physician office billing, coding, and revenue cycle management.
PRACTICE FUSION experience.
Account Payable (A/P) and Accounts Receivable (A/R).
Personnel management and payroll systems.
Knowledge of compliance, workplace safety/OSHA, HIPAA and other regulatory issues.
Excellent interpersonal and communication skills.
Strong attention to detail, impeccable organizational skills and high work ethic.
Fiscal management and human resource management techniques.
Accounting systems, budgeting, insurance billing, revenue management, and collections.
Medical billing procedures and medical insurance.
Managed-care contracting requirements.
Insurance.
Regulatory Compliance and Service Standards.
CPT and ICD coding as applied in physician practices for billing and clinical purposes, including ICD10.
Basic computer skills, including proficient use of the Microsoft Office Suite of products.
Interfacing with vendors, accountants, and other professionals that supply service to the company.
Proven track record in growing physician practice revenues and volumes.
Medical billing.