Medical Billing Specialist, Pre-Surgery Collections

Medical Billing Specialist, Pre-Surgery Collections Ear Nose and Throat Consultants of East TN Knoxville, TN Job Details Full-time $16.00 - $18.50 an hour 3 hours ago Benefits Vision insurance 401(k) matching Qualifications Revenue cycle management Accounts receivable Managed care

ICD-10 CPT

coding Medical terminology

Full Job Description Responsibilities:

RECEIVE LISTS OF SCHEDULED PATIENTS FROM PRE-AUTH TEAM ON A REGULAR BASIS. THIS REQUIRES RESEARCHING EACH PATIENT BY PULLING UP EACH ACCOUNT INDIVIDUALLY. ORGANIZING INFO ON SPREADSHEET IN ORDER TO KEEP A ROLLING LIST BY DATE OF SERVICE.

RESEARCH AND DATA COLLECTION/ENTRY IS ESSENTIAL TO ENSURING ACCURACY. COLLECT PRIMARILY FROM PATIENTS W COMMERCIAL INSURANCE

(double checking insurance on file is accurate so that we're not collecting on patients with Medicaid, Medicare w/Secondary, Primary & Secondary, DSN plans, Federal policies/Govt agencies/VA/Workers Comp. Also reviewing clinical information in encounter to ensure accuracy.

Example:

a code is listed in the billing note by the auth team, but the clinician specifies it's bilateral. In that case, if that detail was missed, the calculation would be inaccurate and my collection would be as well, resulting in lost revenue).

PULLING UP EACH ENCOUNTER/SCHEDULED PROCEDURE/APPOINTMENT. REVIEWING AUTH TEAM NOTE DETAILS AND CLINICIAN NOTE RE

PROCEDURES

TO OBTAIN CODING INFORMATION.

SEARCHING CPT CODES SPECIFIC FEE SCHEDULES TO OBTAIN CONTRACTED RATE INFORMATION. CALCULATING FEES THEN TRANSFERING THAT INFORMATION TO SPREADSHEET.

MONITORING SPREADSHEET DAILY TO FOLLOW UP ON ANY UNPAID DEPOSITS.

MAKING CALLS TO COMMUNICATE DIRECTLY WITH PATIENTS AND COLLECT PAYMENTS. THIS INCLUDES EXPLAINING CALCULATIONS/FEES AND EDUCATING PATIENTS WHAT WE'RE COLLECTING, WHY AND HOW WE GOT TO THAT FIGURE.

MANAGE FINANCIAL TRANSACTIONS BY PROCESSING PAYMENTS VIA CONVERGE. CREATING END OF DAY SPREADSHEET AND REPORTING TO CORPORATE PAYMENT SPECIALISTS.

MAINTAINING THOROUGH AND ACCURATE RECORDS OF CONTACTS & ATTEMPTED CONTACTS, AS WELL AS PAYMENTS COLLECTED BY NOTATING ACCOUNTS

(must be noted in several places including billing notes in pt hub, and a telephone encounter created if follow up is required)

PROCESSING END-OF-DAY DAILY FOR PAYMENTS COLLECTED.

REVIEW EMAILS AND VOICEMAILS DAILY RETURNING PATIENT CALLS & PERFORMING ANY FOLLOW UP.

TAKING CALLS FOR PATIENTS WHO REQUEST TO KNOW WHAT FEES ARE FOR PROCEDURES

WORKING TELEPHONE ENCOUNTERS.

CPT POSTING REPORT

as given by Corporate Billing Manager.

MOVING CREDITS TO CLAIMS WITH OPEN BALANCES.

CREATING NOTES/INSTRUCTIONS FOR PROCESSES.

IDENTIFYING AREAS OF OPPORTUNITY FOR OPTIMIZING RESULTS TO IMPROVE PATIENT SATISFACTION AND INCREASED REVENUE.

• Work diligently, increasing knowledge of coding in both CPT and ICD10 areas. This position requires a great deal of research in making sure our surgery codes are correct, according to the information provided.
• Attend all billing office meetings and reply to all inter-billing office correspondence in a timely, professional manner, if the schedule permits.
• Effectively communicates with other departments and clients to request information, as well as to review issues, concerns affecting reimbursement.
• Learns and remains knowledgeable about patients and types of services being rendered.
• Maintains up-to-date knowledge of governmental and managed care policies and procedures. Demonstrates ability to interpret and communicate regulations to ensure compliance.
• Refers to coding materials, ICD10, CPT and HCPCS, as needed.
• Demonstrates ability to audit and review accounts for reimbursement based on knowledge of billing regulations, medical terminology, and coding requirements.
• Interprets patient and insurance issues and determines resolutions in a timely and accurate manner.
• Makes recommendations to management, actively participates in continuous quality improvement, and enhances reimbursement.
• Adheres to organizational policy with particular attention to standards of conduct and to confidentiality as it relates to HIPAA.
• Relays to MA's and Pre-Auth Staff as needed, even the MA Supervisor and Corporate Billing Manager if receiving no response.
• Work closely with the Corporate Billing Manager on any issues that arise.
• Responds to phone and mail correspondence in a timely, professional manner.
• Make sure all documents are entered into the Billing Shared Drive.
• When you are out, please reach out to another team member if needed, for any tasks to be performed, or catch up upon your return (if this is not an extended period).
• Any other projects as assigned by Management (eventually working Parkwest patient aging accounts).
• Assist Corporate Billing Manager, Operations Manager and Supervisor and other Divisional Managers as needed.

Job Type:

Full-time Pay:

$16.00 - $18.50 per hour

Benefits:

401(k) matching Vision insurance Ability to

Relocate:

Knoxville, TN 37916: Relocate before starting work (Required)

Work Location:

In person