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East Providence

    Billing Specialist - East Providence, United States - University Orthopedics

    University Orthopedics
    University Orthopedics East Providence, United States

    3 weeks ago

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    Description
    Job Description

    Job Description


    Job Title:
    Surgical Facility Billing Specialist

    Reports to:
    Finance Manager


    GENERAL SUMMARY OF DUTIES:
    The Surgical Facility Biller is responsible for billing all diagnosis and procedures with proper codes. The Biller is responsible for record maintenance, daily charges and preparing and submitting claims to the payers. The Biller will work collaboratively with the central billing office, surgical facility staff and accounting team. The Biller will process adjustments, credit balance review and audits when needed. The Biller will verify insurance and calculate patient responsibility.


    Essential Job Functions:
    Ensures that all scheduled or performed cases are accounted for and billed
    Assigns diagnosis and procedure codes for each case
    Verifies accuracy of insurance payments and adjustments received/posted
    Prints and mails patient statements on a frequent basis
    Submits insurance and patient bills
    Posts refunds on accounts
    Processes claims electronically or by mail
    Monitors logs to ensure claims were submitted and received properly, and follows up with insurance companies to ensure receipt of bills
    Reviews and corrects rejected claims and re-bills in a timely manner
    Maintains charge entry on a daily basis
    Reviews and processes contractual adjustments
    Responds to all billing related inquiries and interacts with patients when required to bring account to closure and make financial arrangements
    Answers telephone and returns calls in a timely manner
    Verifies Insurance and calculates patient responsibility
    Processes patient payments daily
    Additional duties as assigned by the Manager to meet department needs.


    Requirements:
    Minimum of 2 years' experience in a physician/medical office, ambulatory surgery center, or hospital business office environment in billing required
    CPC certification preferred, but not required
    Strong CPT and ICD-10 knowledge, aging and collection processing
    Orthopedics surgical billing experience preferred
    Ability to work independently but also a team player; offers team member support and guidance
    Interpersonal skills to deal effectively with patients, physicians and staff
    Strong organizational skills
    Ability to follow collection account to a successful conclusion
    Knowledge of third-party billing and other collection skills

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