The specialist is responsible for managing the revenue cycle, including billing, collections, and resolving claim denials for ENT specialty offices. They must also provide reimbursement assistance to patients while maintaining accurate records and adhering to HIPAA guidelines.
Job Details: Level: Experienced, Job Location: ESP Executive Offices - Dallas, TX, Position Type: Full Time, Education Level: High School, Salary Range: Undisclosed, Travel Percentage: None, *THIS IS A REMOTE POSITION*
RESPONSIBILITY:
Primarily responsible for effective billing and collections for all ENT Specialty Partners offices. Is able to resolve claim issues by utilizing knowledge of company policies and procedures, medical coding, insurance reimbursement practices, and collection laws. Must have experience with hearing aid claims processing and follow-up, including understanding payer benefits, coverage limitations, claim submission, denial resolution, and patient responsibility.
POSITION RESPONSIBILITIES:
This position is responsible for all AR follow up including denials, reconsiderations, and appeals
Accurate data entry of information into the computer system
Provide reimbursement assistance to patients while providing superior customer service and respect to patients and their families
Follow appropriate HIPAA guidelines provide medical records to primary care provider, insurance carriers, referred providers and patients per patient request
Work well individually and in a team-environment accomplishing set goals
Timely and accurate filing and billing of all patient transactions (billing, invoices, and insurance claims, etc.)
Monitor claim status, contact and follow up with insurance carriers on denials
Answer/respond to correspondence related to patient accounts
Posting of charges, payments, adjustments and related activities in EHR. Coordinates with providers, when necessary, on incomplete information to assure proper account and claim adjudication
Answer phones, take messages and return calls
Work well individually or in a team environment accomplishing set goals
Ability to maintain confidentiality
Performs other related duties as assigned
Qualifications: MINIMAL REQUIREMENTS:
High School Diploma or equivalent
Minimum 5 years recent experience in medical billing and collections
Must have experience with hearing aid claims processing and follow-up, including understanding payer benefits, coverage limitations, claim submission, denial resolution, and patient responsibility
Experience using eClinicalWorks (eCW) billing system preferred
Understanding of medical claims and coding
Medical billing and collections in a physician office setting preferred
Basic math skills and accurately process money transactions (must be able to read & understand an EOB)
Experience with office equipment: multi-functional printer/copier/fax, multi-line phone system, calculator, postage machine, and so on
Must be proficient using the computer, data entry, and have above average typing skills
Experience with MS Office, EMR/EPM systems, eClinicalworks is a plus
Prior experience with ENT specialty a plus
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