- Posts missing charges when discovered
- Reprocesses all paper and electronic claims for assigned carriers when required — verifies completeness of insurance claim information before sending
- Reviews edit reports from clearinghouse daily and resolves issues so claims can be processed
- Follows up on rejected claims the day that the rejected EOB is received
- Using data from the monthly aged accounts receivable report, calls payors or looks up claims status online to inquire about unpaid insurance claims that are 45 days old; records response or activity in the computer system "notes"
- Makes necessary arrangements for medical records requests, completion of additional paperwork, etc., if payors request this information prior to payment of claims
- Responds to written and telephone inquiries from patients and insurance companies; manages relationships with personnel from assigned carriers
- Meets with Billing Manager regularly to discuss and solve reimbursement and insurance follow up problems
- Calls carriers to appeal payments that do not match contractual agreement; notifies Billing Manager of payors for which this is a consistent problem; works with Billing Manager and physicians to obtain appeal language for denials and/or unacceptable payment
- Processes requests for insurance refunds, and submits to Billing Manager for approval
- Check payors monthly updates on medical policy/guidelines and report to supervisor
- Establishes payment plans within approved guidelines—obtains approval from the Billing Manager when necessary
- Resubmits insurance claims on behalf of patients, if necessary
- Recommends to Billing Manager those accounts needing to go to an outside collection agency and sends out collection letters
- Prints and mails itemized statements to those patients who request them, or transmits claims to outside mailing house for processing
- Processes requests for patient refunds, and submits to Billing Manager for approval
- Meets with Billing Manager, as necessary, to discuss and solve collection problems
• Assist patients on claims processing if needed - Posts adjustments, withholds, as part of this process, and transfers deductibles and coinsurance to patient responsibility; batches them according to protocol
- Alerts Billing Manager when payments do not match contractual amounts; looks for underpayments and silent PPOs
- Submits balanced payment batches to the Billing Manager daily
- May be required to post all mailed-in payments and electronic payments by line item (in absence of Poster)
- Ensure all medical information for patient is accurate, updating when necessary
- Check patient eligibility and benefit verification; update account if discrepancies
- Document all actions taken; scan all documents sent out to payors (ex: appeals paperwork)
- Ensures that all faxes are cleared off the machine (or routed in the system) and distributed throughout the day
- Sorts incoming reports and directs to appropriate person if not addressed properly
- Maintains detailed knowledge of practice management and other computer software as it relates to job functions
- Maintains and respect the confidentiality of patient information in accordance with company policy & procedure, and HIPAA & compliance guidelines
- Attends regular staff meetings and continuing education sessions as requested
- Presents professional image in manner, appearance, motivation and work habits
- Regular attendance is required
- Performs other duties as assigned
- Academic/Technical Qualifications
- HS diploma or GED required
- Minimum of 18 months experience in a physician group practice billing department
- Familiar with CPT and ICD-10-CM coding for orthopedic, podiatry & pain management surgery procedures
- Good analytical skills and an affinity for detail
- Knowledge of HIPPA & OSHA guidelines
- Working knowledge of medical practice management systems and electronic medical records
- Basic knowledge of computers and medical terminology is mandatory
- Excellent verbal, written, and interpersonal skills
- Ability to work well with physicians, employees, patients, and others
- A committed and result-driven attitude to work as a high ethical and professional standard.
- Unquestionable commitment to confidentiality, quality customer service and professionalism.
-
Collections Specialist
2 weeks ago
Core Force / Information Solutions Edison, United StatesWe have an immediate opening for a Collection Specialist here at Core Force. · Job Summary: · **Major Responsibilities include but are not limited to**: · Collections: · - Track and resolve outstanding payment issues and generate weekly aging reports in a timely manner. · - Initi ...
-
Collections Specialist
1 week ago
Runwise New York, United StatesRunwise is seeking a highly motivated, results-oriented, and tenacious **Collections Specialist** for our growing team. · As a Collections Specialist at Runwise, you will have the opportunity to collaborate with a variety of real estate organizations from large owners to individu ...
-
Collections Specialist
2 weeks ago
Grun management Paterson, United StatesTitle: Bilingual Rent Collection & Lease Specialist Wanted · **Job Type**: · property management company seeking a highly skilled and bilingual professional to join our team · Job Summary: · As a Bilingual Rent Collection & Lease Specialist, you will play a vital role in ensuring ...
-
Collections Specialist
1 week ago
Intellectt Inc Princeton, United States**Title**: Collections Specialist · **Place**: Princeton, NJ · **Duration**:06 Months · **Shift Timings**:8am - 5pm(M-F) · **Hybrid work - Tues-Thurs in office / M & F at home** · - Specifically, experience in managing chargebacks and rebates. · **Top 3 must have skills**: · - St ...
-
Collections Specialist/medical Collections
1 week ago
PremierLifeSciences Princeton, United States**Role : Collections Specialist III** · **Location : Princeton, NJ ** · **Duration : 6 Months** · - Collections Analyst · - Temp Position · - M-F 8am - 5pm · - Hybrid work - Tues-Thurs in office / M & F at home · - Specifically, experience in managing chargebacks and rebates. · * ...
-
Collections Specialist
3 weeks ago
RD Management LLC New York, United StatesResponsibilities: · Must have prior experience with collections in real estate office and be highly proficient in Outlook, Excel, Word and MRI Software. · Full-time office position, with 1 day a week remote option upon successful completion of trial period. · Salary commensurate ...
-
Collections Specialist
1 week ago
ChutePlus llc Valley Stream, United StatesPay: $54, $60,000.00 per year · **Benefits**: · - 401(k) · - Health insurance · - Paid time off · Weekly day range: · - Monday to Friday · Work setting: · - Office · **Experience**: · - Microsoft Excel: 1 year (required) · - Customer service: 2 years (required) · - Accounts recei ...
-
Collections Specialist
2 weeks ago
East Coast Petroleum Bronx, United StatesWe are seeking a Collections Agent to contact customers for payment while maintaining diligence in professional correspondence. · **Duties and Responsibilities** · - Collection calls and/or correspondence in a fast-paced goal-oriented collections department · - High volume phone ...
-
Collections Specialist
2 weeks ago
ChutePlus llc Valley Stream, United StatesPay: $52, $60,000.00 per year · **Benefits**: · - Paid sick time · - Paid time off · Weekly day range: · - Monday to Friday · Work setting: · - Office · **Experience**: · - Microsoft Excel: 1 year (required) · - Customer service: 2 years (required) · - Accounts receivable: 3 year ...
-
Collections Specialist
3 days ago
ChutePlus llc Valley Stream, United StatesPay: $60,000.00 per year · **Benefits**: · - 401(k) · - Health insurance · - Paid time off · Weekly day range: · - Monday to Friday · Work setting: · - Office · **Experience**: · - Microsoft Excel: 1 year (required) · - Customer service: 2 years (required) · - Accounts receivable ...
-
Billing and Collection Specialist
2 weeks ago
GreenPoint Technologies East Brunswick, United StatesThe Billing and Collection Specialist will be responsible for various tasks associated with the Revenue Group. Such tasks include editing proforma, assisting with the various tasks associated with e Billing, following up on Client's Receivables, and assisting with revenue adjustm ...
-
Commercial Collections Specialist
2 weeks ago
LCF Group New Hyde Park, United StatesThe LCF Group (_**located in New Hyde Park**_)_ is an established MCA direct funder. We provide funding to small businesses in the form of a merchant cash advance. We purchase their future receivables and are repaid via daily ACH debits or a percentage of their credit card sales. ...
-
Commercial Collections Specialist
2 weeks ago
The LCF Group, Inc. New Hyde Park, United StatesThe LCF Group (_**located in New Hyde Park**_)_ is an established MCA direct funder. We provide funding to small businesses in the form of a merchant cash advance. We purchase their future receivables and are repaid via daily ACH debits or a percentage of their credit card sales. ...
-
B2b Collections Specialist
2 weeks ago
Informa Global Support New Hyde Park, United States**Company Description** · **Informa** is a leading international events, intelligence and scholarly research group. · We're the specialist's specialist. Through hundreds of powerful brands, we work with businesses and professionals in specialist markets, providing the connections ...
-
Medical Collections Specialist
3 weeks ago
SLA Associates, LLC dba IDCC Health Services Brooklyn, United States**Overview**: · **Duties**: · - Negotiate settlements for past due claims · - Maintain updated ledgers and spreadsheets · - Make follow up calls to resolve any outstanding or denied claims · - Submit appeals on claims that are denied or partially paid · - Submit resubmissions of ...
-
Ar Collections Specialist
2 weeks ago
Baldor Specialty Foods Bronx, United StatesAt Baldor, we ask all our applicants to complete a Culture Index Survey as part of the interview process. To save time, please copy and paste the link below into a Google browser and follow the instructions to complete the survey._ · - **Please note that you still must complete t ...
-
Billing & Collection Specialist
3 weeks ago
Sunnyside Manor Township of Wall, United StatesCompile data, compute fees, and prepare invoices for billing purposes. Duties include computing costs and posting data, and keeping other relevant records. · **Benefits** · Medical insurance · 401K with company match · Employee Referral Program · Parking available · **Culture** · ...
-
Collection Specialist- Paralegal
3 days ago
Stellar Management New York, United States**Collection Specialist** · **Reports to: Associate General Counsel** · **Position Summary** · Initiate and manage legal processes with tenants who fail to comply with the terms and conditions of leases and other legal agreements. · **Responsibilities** · - Reviewing arrears repo ...
-
Billing and Collection Specialist
4 days ago
Modern Pest Services Brunswick, United StatesAt **Modern Pest Services, **we know how important it is to protect homes, businesses and industries from damaging and disease-carrying pests. We understand the impact pest control has on public health, safety, and quality of life. · To support the needs of our community, **Moder ...
-
Medical Collections Specialist
6 days ago
NYBRA Plastic Surgery Great Neck, United StatesNYBRA Plastic Surgery, a cutting-edge plastic surgery practice, is seeking an experienced, professional and reliable individual for the position of **Medical Collection / Revenue Cycle Specialist** for our Great Neck office. · Our award-winning, board-certified plastic surgeons, ...
Billing & Collections Specialist - Linden, United States - Union County Orthopaedic Group
Description
Job Description
Job DescriptionDescription:The Billing & Collections Rep follows up on rejected claims and overdue insurance and patient balances using EOB forms and reports; builds and maintains relationships with specified payors; manages patient A/R, statement processing and considers accounts for outside collections
Requirements:Key Responsibilities include the following:
Charge Entry
Claims Filing
Claims Account Follow-Up
Patient Accounts
Payment Posting
General
Shared Duties/Other
Critical Skills & Attributes
Industry Experience
Communication Skills