Billing Specialist

Since 1958, The Ear, Nose, Throat & Plastic Surgery Associates has combined quality patient care with state‑of‑the‑art innovation. With a tradition of excellence more than 50 years strong, our goal is to serve our patients’ individual needs and exceed their expectations. We are uncompromisingly dedicated to excellence and achieving quality results for every patient that chooses to visit us.

Primary point of contact for inbound patient billing calls, resolving inquiries and discrepancies. Communicate with patients and insurance carriers to support claim integrity, root cause analysis, accuracy, and resolution on all patient accounts. Handle charge entry, charge approval, payment posting, over payments, clearinghouse and payer rejections, custom claim edits, and accounts receivable follow up on denied, underpaid, or no payment activity.

Monday – Friday, 8:00 am – 5:00 pm. Eligible for a fully remote position.

• Serve as primary point of contact for inbound patient billing calls, resolving inquiries and discrepancies.
• Complete gap analysis and identify root causes of issues/errors in all workflows to suggest process improvement.
• Research and accurately utilize technology – payer portals, lockbox, clearinghouse, practice management & EHR billing system, Microsoft, Email, Teams, Word, Excel, PowerPoint.
• Maintain high level of customer satisfaction, professionalism, and courtesy during all transactions.
• Meet or exceed weekly and monthly performance metrics of production, quality, and attendance and department KPI set for role.
• Daily reconciliation and reporting required to include production/performance self‑reporting.
• Accurate and timely data entry of charges, payments, adjustments, edits, denials, underpayments, over payments, or no payer response claims.
• Learn and master billing system regarding all aspects of data entry, billing inquiries, and other tools and functions.
• Consistently demonstrate proficiency at explaining all services to insurance carriers and patients.
• Collaborate and partner with team and other departments to resolve patient and/or insurance issues.
• Follow ENTPSA policies & procedures, including letter generation, collection phone calls and standard appeal template documentation.
• Responsible for peer training and quality assurance when needed.
• Follow corporate collection policies & procedures, including letter generation, collection phone calls and required collection documentation.

• Patient Account Billing Line
• Charge Management – Charge Entry & Charge Approval
• Payment Posting
• Overpayment & Non‑Contractual Adjustments
• Accounts Receivable Follow Up & Claim Management
• Training & Quality Assessment
• System Configuration & Maintenance
• Understand claim form logic/claim edits and configure system as appropriate.
• Update charge master and/or payer fee schedules as appropriate.

• Read, write, speak, and understand English. Spanish is a plus.
• Work remotely with little supervision.
• Apply appropriate collection techniques and demonstrate sustained achievement of stated goals.
• Use personal computer and appropriate software applications to include billing system and other role‑related tools.
• Effective verbal and written communication skill.
• Effective organizational skills.
• Prioritize and organize effectively.
• Show judgment and initiative to accomplish job duties.
• Perform job at workstation for prolonged periods of time.
• Computer savvy using applications Microsoft Office, Windows PC, Excel, practice management systems, etc.
• Effectively present information and respond to questions from patients and insurance carriers in a clear, straight forward, and professional manner.
• Calculate figures and amounts such as discounts, proportions, percentages, and volume.
• Solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
• 3 Years experience or more as a Billing Specialist.

• High School Diploma required; college degree or college credits preferred.
• RCM or medical billing certification or coding certification such as CPC or CCS‑P.

NOTE:

This job description is not intended to be all‑inclusive. Other duties as assigned to meet business needs.