American Health Partners Nashville , TN 37201
Posted 5 days ago
The Medical Billing Specialist for Nurse Practitioners is responsible for processing and mailing/transmitting claims, tracking claims, monitoring authorization and eligibility of payor benefits, managing the collections process and posting cash receipts.
ESSENTIAL JOB DUTIES:
To perform this job, an individual must accomplish each essential function satisfactorily, with or without a reasonable accommodation.
Extract and verify billing information from medical records through VISION software
Contact patients by phone and/or mail regarding accounts
Ensuring collection of past due balances; follow up as needed
Ensure all patient demographic and insurance is accurate prior to submitting claims to insurance companies
Answer patient account inquiries; assists establish alternative payment plans when necessary
Maintain patient account records; settle third party payer issues as required
Receive and review Daily Reconciliation Review (DAR) document for accuracy; enter charges into Practice Management System (PMS)
Prepare and review patient statements prior to release through PMS
Ensure timely filing of all Medicare, Medicaid, and third-party insurance claims; reconcile all payments with related charges and adjustments
Balance daily charges; reconcile with reports within PMS
Perform follow-ups on all claims submitted in timely intervals established by revenue cycle manager
Collaborate with revenue cycle manager and payers on denials/rejections
Post all third-party payments and applicable contractual allowances to patient accounts
Work closely with practice location representatives to ensure proper insurance verifications and authorizations are obtained
Other duties as assigned
JOB REQUIREMENTS:
Comply with applicable legal requirements, standards, policies and procedures including but not limited those within the Corporate Compliance Program, Corporate Code of Conduct, HIPAA, and Federal False Claims Act
Report concerns and suspected incidences of non-compliance immediately to the Chief Compliance Officer
Communicate professionally with patients and guarantors regarding balances or account information
Participate in required orientation and training programs
Cooperate with monitoring and audit functions and investigations
Participate in process improvement responsibilities
Meet productivity goals
Successful completion of required training
Handle multiple priorities effectively
REQUIRED SKILLS:
Problem solving skills to manage a variety of concrete variables
Effective verbal and written communication skills
Ability to interpret instruction presented in variety of situations
Strong organizational skills; ability to manage multiple projects simultaneously
Proficiency with Microsoft Word, Excel, PowerPoint, and Internet Explorer
Ten key speed and accuracy
Strong written and verbal communication skills
Proficient knowledge of medical billing and coding
Solid knowledge of medical terminology
Required Computer Software/Equipment used:
Various operating systems
Standard office equipment
Microsoft Suite applications
Desktop or laptop computer
REQUIRED QUALIFICATIONS:
o High school diploma or equivalent required
o Associates degree preferred
o Three (3) years' experience in medical insurance billing for nurse practitioners is required
o Experience billing for nurse practitioners in a long-term care setting preferred
SUPERVISORY RESPONSIBILITIES:
WORKING CONDITIONS:
Audio-Visual: Good
Hearing: Good
Ability to lift to 5 pounds
Subject to standing, walking, sitting, and use of hands
Work is typically performed in a standard office environment; well-lit; comfortable temperature-controlled
Above-average conversational noise is frequent
Position may require flexible hours, unscheduled overtime or occasional week-end work
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EEO
This employer participates in E-Verify.
American Health Partners