Billing Specialist III

POSITION SUMMARY:

The Billing Specialist III is responsible for obtaining, reconciling and uploading daily bank deposits. This employee will also maintain assigned payer accounts receivables, including but not limited to working to overturn denied claims, following up on other unpaid claims, researching credit balances, and correcting billing errors.  The representative will also act as a company resource for his or her assigned payers. This employee will be eligible to work from home after 6 months in the position (consideration dependent on performance, productivity and additional training needs). 

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Maintain and reconcile daily bank deposits.
• Act as a liaison between Collections Company (Prince Parker) and Horizon Eye Care.
• Research and correct payer credit balances as necessary. Submit and post refund requests as appropriate.
• Post Self-Pay payments on bank deposits as appropriate.
• Maintain a thorough understanding of the policies and procedures of his or her assigned payer(s), review payer correspondence, and participate in webinars and other educational programs to keep current on these policies.
• Notify management of payer updates that are pertinent to the practice.
• Maintain a solid understanding of current billing and coding guidelines.
• Adhere to all related policies and procedures, and participate in improving departmental issues.
• Work on assigned accounts receivable daily, including researching claim denials and underpayments and collecting unpaid balances from third party payers (up to and including secondary claims status, filing, denials, and working of the encounter).
• File corrected claims or resubmit missing claims to payer(s) for processing and payment.
• Notify supervisor of error or audit patterns or trends.
• Answer telephone promptly and courteously, respond to patient or co-worker questions about balances or billing.  Handle all emails and voicemails daily.
• Collect patient payments according to HEC guidelines as necessary.
• Perform all necessary job functions related to new technological implementations.
• Act as a back-up to Billing Specialist II responsibilities when necessary. 
• Meet productivity goals set by supervisor. 

POSITION  REQUIREMENTS:

Minimum Qualifications: 

1. Strong understanding of payment posting cycle (insurance and self-pay) from all sources.
2. 3 years of accounts receivable / insurance billing experience in a medical office.
3. Solid understanding of CPT and ICD coding and national billing guidelines.
4. High school diploma or equivalent.

Preferred Qualifications:

1. Three years of ophthalmic billing experience.
2. Applicable Coding and Billing certifications.