The Physician Billing Specialist is responsible for managing accounts receivables and perform work log/work queue tasks according to set standards and productivity measurements.
Duties and responsibilities:
Provide professional and courteous service to all customers
Communicate effectively in written and verbal form
Maintain clean, well-organized, properly stocked and secure working area
Maintain complete patient/employer confidentiality at all times per company and HIPAA requirements
Perform job functions in accordance with current departmental Standards, Polices and Procedures
Demonstrate teamwork by assisting coworkers with tasks/training as directed, and attending and participating in mandatory meetings
Accommodates changes in workload within the department
Keep supervisor informed when problems may interfere with work being completed on time
Use initiative to resolve problems with appropriate action and follow through
Review daily assigned tasks through the applications and as assigned according to department goals.
Contact insurance companies, patients, and other third party payers regarding claims status and payment, via telephone and written correspondence according to established standards.
Respond to inquiries and correspondence from insurance companies, patients, and other third party payers in a professional and timely manner.
Refile/rebill claims as necessary, ensuring that all information contained on the claim is accurate and complete.
Review and process denials from insurance companies, process for further review, identifying and initiating appeals as needed.
Audit accounts for any necessary corrections, including updating coverage information.
Maintain working knowledge of current procedural terminology, diagnosis codes, and insurance payer policies.
Provide phone coverage for customer service related calls as needed.
Works with patients to resolve outstanding insurance and/or patient balances according to set standards and policies. This includes preparing accounts for collection.
Set up payment plans with patients and follow up on all payment plans implemented.
Experience and qualifications:
Minimum two (2) years’ experience in patient account billing and collections.
General computer skills, including the ability to use the internet and learn other computer applications
General knowledge of medical terminology and ICD9 coding
Working knowledge of general medical office procedures required
Working knowledge of legal aspects of patient and insurance collections
40 WPM typing, verifiable
10 key by touch
Must have good listening skills and the ability to communicate clearly and effectively
High school graduate or GED equivalent
Certificate of Insurance Billing preferred
Internal Number: MEM003630
About MemorialCare Medical Foundation
Let us introduce ourselves. We're MemorialCare, a nonprofit health system that includes four hospitals, two medical groups, imaging centers, surgical centers and much more. As one of the leading health systems in Orange County and Los Angeles County, we're confident that no matter what your needs are, we have the teams, tools and know-how to support you every step of the way.
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