· High school plus additional training which includes:
Additional business courses
· Associates degree desired, preferably in Business Administration or Accounting
· Successful completion of CBO insurance/ medical terminology/ billing tests within 90 days of hire
· Five (5) years of medical billing of professional charges is required
· Experience with NextGen or eCW is preferred
Effective verbal, written, and interpersonal communication skills with the ability to comfortably interact with diverse populations.
Ability to demonstrate competency with a standard desktop and Windows-based computer system, including a basic understanding of email, e-learning, intranet and computer navigation. Must have knowledge and ability to learn, access and utilize the relevant computer programs listed below within 90 days of hire:
à Navicure Clearinghouse
à Microsoft office
Ability to exercise independent judgment within scope of knowledge and responsibility.
Responsible for various billing functions, including compiling, processing, payment batching, follow-up, customer service, billing inpatient/outpatient professional charges to third party insurance payers on both an electronic and manual basis to meet department standards for claims submission, payment posting and A/R follow-up.
This position's primary customers are the practices of Munson Physician Network. This position reports to the Billing Manager of the Central Billing Office.
Ability to establish priorities and meet tight deadlines with strong problem solving ability.
Routinely keeps current with all third-party regulations and procedure changes and advises the appropriate Munson Physician Network areas of the change/ requirement.
Complete transmission process on electronic billing system for all current claims. Prepares and mails required hard copy claims to insurance companies, patients and other responsible parties.
Assists with policy/ procedure development and maintenance.
Retrieves/ receives payments and timely and accurately posts to the practice management system, electronically and manually.
Balances all monies posted daily and prepares bank deposits
Identifies incorrect insurance payments and/or system adjustments
Identifies and verifies accuracy of credit balances for patients and insurance companies. Performs refund processes according to department standards.
Documents all activity on accounts appropriately to ensure account maintenance is up-to-date for other staff members and insurance follow up
Answers incoming billing inquiry calls from patients and insurance companies.
Acts as a billing resource to the practice locations by communicating changes of billing, daily posting and balancing procedures, answering questions and attending team meetings as needed.
Performs claims denial management and claims appeals
Monitors accounts receivable and works through resolution to keep days in A/R within department standards.
Receives and completes tasks from the practice management system.
Performs other duties as assigned.