Self Pay Collections Specialist
Portland , OR 97213
Posted 3 weeks ago
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Title: Insurance Billing Follow-up (Pharmacy/Infusion)
Portland, OR 97213
Duration: Contract-to-Permanent (Within 6 months depending on performance/attendance)
KEY RELATIONSHIPS: Reports to the Home Services Billing Supervisor.
We are urgently seeking a Billing specialist with the following :
- Conducts thorough follow-up on denied or partially paid claims to ensure that reprocessing occurs within timely billing limits and full reimbursement is made. Notates in billing system follow-up activity in account notes future reference.
- Respond to incoming calls from patients, guarantors, insurance companies or other sources to assist with questions or concerns on accounts.
- Communicates effectively with patients, payers and ancillary departments to independently resolve billing issues.
- Establishes expertise in the line of business (DME) and with the payers (government, commercial, managed care) assigned.
- Identifies process breakdowns as they occur and remedies them or escalates issue to higher authority to resolve.
- Educates themselves continually on payer requirement changes. Maintain up-to-date reference materials to ensure billings meet regulatory requirements.
- Utilize solid judgment and adhere to all policies ensuring the protection of confidential information related to patient demographics, medical information, diagnosis codes, etc. according to both internal and Federal HIPAA regulations and guidelines.
- Seeks out relevant training. Seeks out guidance when uncertain of procedure or policy.
- Performs other related duties as requested by Supervisor or Lead.
The qualifications for the position are the minimum requirements needed to be successful in the position. The level of experience and expertise for the job is determined by the current amount of expertise in the unit/department. If training or experience is not required but would be desirable, it is listed as preferred however, persons without preferred background will be considered in the hiring process.
- Education, Training & Experience (includes licenses or certifications): High school graduate or GED equivalent required. College level courses in medical front office/medical billing preferred.
- Minimum two years health care account management experience. Experience in DME (Durable Medical Equipment) billing strongly preferred.
- Excellent interpersonal communication and public relations skills required.
- Excellent writing skills required.
- Knowledge of medical terminology, ICD-9 coding, HCFA 1500 required.
- Independent thinking and decision-making skills.
- In depth knowledge of regional managed care, Medicare, Medicaid programs.
- Ability to organize and manage time effectively to optimize productivity.
- Ability to work in a fast-paced, high volume environment.
- Ability to maintain flexibility in meeting department as well as personal workload demands