Billing/Collection Technician- Medical Insurance

Job Description : PURPOSE :

This position ensures that the more complex accounts are accurately invoiced, reconciled and outstanding payments are collected so that the core system is correct and the client is satisfied.

This position is responsible for serving as point of contact for internal and external customers regarding all complex billing and collection issues.

The associate will assist in the clarification and development of process improvements and inquiries, assure payments related to services from all sources are recorded and reconciled timely in order to maximize revenues.

The incumbent may be required to assist with projects for upper management by providing analytical and reporting support for such purposes as : operational efficiency / quality metrics and productivity analysis, end-of-month accounts receivables reconciliation, and monthly account aging reports.

ESSENTIAL FUNCTIONS :

Researches and responds by telephone, or in writing to complex patient inquiries regarding billing issues and problems.

Reviews billing forms for accuracy and completeness before sending to payors.

Assists in the preparation of monthly billing and accounts receivable reports.

Assists with complex billing issues, including contacting insurance carriers to confirm patient eligibility and referral information.

Ensures all insurance, demographic, and eligibility information is obtained from patients and entered into the system in an accurate and timely manner.

Adhere to HIPAA guidelines and other relevant state and federal regulations, and company policies regarding to compliance, integrity, patient privacy and ethical billing practices.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and / or ability required. Reasonable

accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education Level : High School Diploma or GED

Experience : years experience in a Billing, membership enrollment, member services, claims operations or Finance role

Preferred Qualifications

Knowledge, Skills and Abilities (KSAs)

Proficient in Microsoft Office applications., Advanced

Provide excellent customer service with a focus on department goals., Advanced

Works well in environment with firm deadlines; results oriented., Advanced

The incumbent is required to immediately disclose any debarment, exclusion, or other event that makes them ineligible to perform work directly or indirectly on Federal health care programs.

Must be able to effectively work in a fast-paced environment with frequently changing priorities, deadlines, and workloads that can be variable for long periods of time.

Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.

Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.