Medical Billing Specialist II - AR Aging

Description

Job Title: Medical Billing Specialist 2

Job Family: Patient Services

Department: Billing

Reports to: Business Office Manager

Classification: Non-Exempt Status: Full Time

Date Updated: May 2023

We pursue excellence in the delivery of professional, compassionate, and complete eye care.

• Empathy | Seek to understand others’ feelings and perspectives.
• Extend Grace | Offer kindness and forgiveness.
• Desire to Help People in Need | Strong sense of social responsibility.
• Desire to Work | Perform your job regularly, consistently, and to the best of your abilities.
• Invest in Yourself | Never stop learning.

A successful Medical Billing Specialist (MBS) is responsible for actions that support and safeguard Fogg Remington Eye Care (FRE) Standard of Patient Care. As an MBS, you will juggle multi-tasks simultaneously and regularly complete ad hoc projects. The workday goes by quickly, and no two days are exactly alike. The MBS should be committed to the Company’s strong learning culture and creating a positive patient experience.

An MBS is responsible for managing the billing process, ensuring that claims are processed accurately and in a timely manner. The MBS will prepare and submit claims to insurance companies and other third‑party payers.

• Enter Explanation of Benefit or Payment information from external sources into Practice Management System.
• Review and update patient demographics in Practice Management System.
• Interact with patients regarding outstanding balances to minimize patient collections.
• Identify recurring issues in billing process. Resolve and/or elevate as required.
• Follow procedures to produce statements for patients.
• Review pre‑billing reports for conformance with billing requirements and make changes as required.
• Process and export claim information and deliver electronically or physically to the appropriate insurance company.

• Recognize and speak with insurance staff regarding insurance denials, aged reports, and other billing issues.
• Determine the next steps to reprocess claims being appealed or rebill claims that have not been paid.
• Enter charges into Practice Management System and review information for accuracy and alignment with proper billing sx.
• Run and review reports to identify errors or post missing charges.
• Identify and process unapplied credits.
• Process payment information that may not be a 1:1 format to Nextgen system, using best judgement and procedures to accurately post payment information.
• Process charges for No Show visits.
• Enter optical claims information into the appropriate external insurance system.

• Cross‑train in relevant/related functions and roles as necessary, and assist/train other staff in related functions as needed.
• Has not been sanctioned or excluded from participation in federal or state healthcare programs by a federal or state law enforcement, regulatory, or licensing agency required.
• Maintain confidentiality by safeguarding ePHI and demonstrating HIPAA compliance to our patients.
• Ensure that HIPAA privacy policies are clearly understood and followed.
• Present a positive view of FRE to the community.
• Protect company assets.
• Support all co‑workers and treat them with dignity and respect.
• Support the team to reach common goals.
• Be able to think and act quickly and efficiently in emergencies.
• May be scheduled to work at different locations as necessary, reporting to the location at the beginning of the day.
• May drive on company business.
• Must have valid Dessert California driver’s license (required).
• Comply with all FRE policies and procedures, including but not limited to workplace safety, reporting work‑related injuries, Infection Control, and preventing potential safety risks for staff, clients, and others.
• Punctual and regular attendance is an essential responsibility of each employee loyees are expected to report to work as scheduled, on time, and prepared to start working. Employees are expectedégation to remain at work for their entire work schedule. Late arrival, early departure, or other absences from scheduled hours are disruptive and…