Billing Specialist

Description

JOB SUMMARY: The Billing Specialist is responsible for collecting, posting, and managing account payments, as well as, submitting claims and following up with insurance companies on a daily basis.

CHARACTERISTIC JOB TASKS AND RESPONSIBILITIES:

• Prepares and submits clean claims to various insurance companies either electronically or by paper;

• Submits, reviews, and updates dental insurance pre-authorizations. Reviews outcome with student and/or patients as needed;

• Performs daily insurance eligibility for insurance patients for all LECOM Dental Clinics;

• Works directly with 3rd party insurance biller to ensure successful claim submission and payment allocation;

• Answers questions from patients, faculty, staff and insurance companies;

• Identifies and resolves patient billing complaints;

• Prepares, reviews, and sends patient statements;

• Evaluates patient's financial status at the direction of the Director of Practice Finance and/or his/her designee;

• Follows and reports status of delinquent accounts;

• Reviews accounts for possible assignment and makes recommendations to the Director of Finance, PCC -Supervisor, and/or his/her designee;

• Prepares various information for the collection agency on an as-needed basis;

• Performs daily backups on office computer system and associated office programs (i.e. AxiUm …etc.);

• Performs various collection actions including, but not limited to, contacting patients by phone, correcting and resubmitting claims…etc.;

• Processes payments from insurance companies and prepares a daily deposit;

• Participates in educational activities and attends monthly staff meetings as designated;

• Conducts self in accordance with LECOM's employee handbook;

• Maintains strictest confidentiality; adheres to all HIPAA / FERPA guidelines/regulations;

• Must work in conjunction with the faculty & students to maintain patient flow;

• Protects money, checks, credit cards, and insurance information;

• Contribute directly to the Mission of LECOM embodying the essence of Osteopathic Principles and Practices by assisting with Institutional fundraising and participating in the LECOM Scholarship Auction;

• Participate in scholarly activity so to enrich and broaden the student learning experience;

• Commit to being a representative of LECOM by being actively involved in the community, including, but not limited to, serving on Boards, participating in community fundraisers and overall outreach; and

• Accept other duties needed/assigned for the practice needs.

EEO/AA/M/F/Vets/Disabled

Minimum Requirements

KNOWLEDGE, SKILLS, ABILITIES AND PERSONAL CHARACTERISTICS: Must possess required knowledge and be able to explain and demonstrate, with or without reasonable accommodations, that the essential functions of the job can be performed.

• Knowledge of dental billing/collection practices (i.e. dental Insurance and reimbursement), specifically with state Medicaid Dental Plans;

• Knowledge of business office procedures;

• Knowledge of basic dental coding and third-party operating procedures and practices;

• Ability to operate a multi-line telephone system;

• Proficiency in answering a telephone in a pleasant, polite, and helpful manner;

• Ability to read, understand, and follow oral and written instructions;

• Compliance with State and Federal Regulations and Safety Protocols at the practice level.

• Knowledge of patient's privacy (HIPAA) and student privacy (FERPA);

• Follow proper OSHA and safety guidelines;

• Protect equipment (office, dental, facility);

• Strong communications skills are essential as well as computer literacy (MS Office Suite - Word, PowerPoint, Excel, etc.) and accurate data entry skills;

• Maintaining an established work schedule and one's work area in an orderly manner;

• Effectively using interpersonal and communication skills including tact and diplomacy;

• Effectively using organizational and planning skills, including attention to detail and follow-through;

• Assessing and prioritizing multiple tasks, projects, and demands;

• Ability to establish and maintain effective working relationships with patients, employees, and the general public;

• The ability to work cooperatively and collegially with others, consistent with a workplace of dignity and respect and EEO rules and regulations;

• The ability to report to work as scheduled, ready to devote full attention and energy to the important work of LECOM;

• The ability to accept work directives from managers and supervisors in a respectful and cooperative manner; and

• Be able to be flexible to accept other duties needed/assigned for the practice needs.

MINIMUM QUALIFICATIONS:

Education and experience equivalent to: High school diploma or GED required; AS or BS degree optional. Work experience in a similar job responsibility preferred. Computer and online interactive knowledge a must.