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Medical Billing and Coding


JOB DESCRIPTION
POSITION: Billing Specialist II
DEPARTMENT: Billing
REPORTS TO: Billing Supervisor
JOB
Summary:
Responsible for accurately submitting reviews and appeals, answering billing questions from staff and patients, preparing and submitting refund/write-off requests, checking daily superbills, submitting claims, posting EOBs, confirming payments for all upgraded lenses, and confirming payments received for RCNE surgery patients.

Education and
Experience:
High school diploma or equivalent
Insurance experience preferred
Work minimum of two years in a medical office or one year in medical office with one year of schooling.
One year of employment at NELC.
Prerequisite knowledge: Billing Specialist I.

Essential Skills and AbilitieS
Excellent communication skills.
Strong mathematical and problem solving skills.
Ability to work as a team member.
Management of multiple tasks simultaneously.
Working knowledge of standard accounting principles.
Capacity to demonstrate trust and loyalty to practice.
Organizational skills with attention to detail.
Reading and understanding EOBs.
Understanding of AdvantX, including unapplied money.
Train front office checkout.
Train new billers.
Ability to pass drug test.

Responsibilities:

Any and all duties assigned by management with an emphasis on the following:

Daily
Submit UHC claims to UHC online.
Call Medicare and get pending claims.
Post Medicare and commercial insurance payments.
Work denials; send reviews/appeals/Q2 appeals as necessary.
Answer patient and staff billing questions.
Fill out refund/write-off requests.
Check daily superbills.
Transmit electronic and submit paper claims.
Work on collecting accounts receivable/patient delinquency using Excel grid and beginning with the highest and oldest balance due, working down to the lowest and newest balance due.
Support/assist other billing specialists with excess work as needed.

Weekly
Go thru pending write-off and refund request folder: check accounts, if cleared, prepare & submit for approval.
Download and print UHC Electronic remits and EOBs and post them for NELC and RCNE.
Check surgery schedule for any money due on surgery patients for NELC and RCNE including upgraded lenses.

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