Original listing text, shown exactly as published by the company.
What you’ll do
- Utilize expertise in OB/GYN billing processes to investigate and resolve insurance denials through
effective communication with payers and attention to detail in claim resubmissions
- Navigate various payer portals to monitor claim status and eligibility and resolve issues promptly
- Collaborate with internal teams to gather and provide necessary appeals and claims processing
documentation
- Maintain up-to-date knowledge of medical billing regulations and compliance requirements
- Utilize medical collection practices and procedures to manage outstanding accounts receivable
- Ensure accuracy in data entry and record-keeping for billing-related activities
- Prioritize tasks effectively to meet deadlines and achieve goals
Core Revenue Cycle Functions
- Complies with Revenue Cycle policies and procedures
- Works assigned task lists, work queues, work files and reports
- Maintains current knowledge of third-party payor reimbursements and managed care contracts
- Maintains knowledge and is familiar with physician billing, accounts receivable, and EHR systems
- Utilizes and identifies all components of Explanation of Benefits (EOB)/Explanation of Payments (EOP)
- Accurately counts and tracks all daily activities and production
- Completes and accurately documents activity or communication on accounts
- Meets department production standards consistently as defined by department management
- Works special projects as assigned by Manager, Supervisor, or others
Knowledge, Skills, Abilities
Language/Communication Skills
- Skill and ability to communicate effectively both verbally and in-writing
- Ability to read and comprehend simple instructions, short correspondences, and memos
- Ability to write
simple correspondence
- Ability to effectively present information in one-on-one and small group
situations to customers, clients, and other employees of the organization
Mathematical Skills
- Adds, subtracts, multiplies, and divides in all units of measure, using whole numbers, common fractions,
and decimals
- Ability to understand and calculate figures and amounts such as simple discounts, interests, and
percentage measures and to read tabular and bar graphs
Computer / Technical Skills
- Skill and ability in Physician Billing Systems (PB), Electronic Medical Records (EMR), and Microsoft
Office applications with working usage of MS Word, Outlook, and Excel
- Extensive knowledge on use of email, search engines, Internet, and ability to effectively use payor
websites and portals
- Requires proficiency with various healthcare computer system applications that are used by physicians
in the office and in hospital settings to support patient care, billing, and financial information.
Customer Service Skills
- Ability to advocate on patient’s behalf, listen to patient concerns attentively, and address patient matters
promptly, courteously, and respectfully.
Qualifications
- High school diploma or GED required
- 3 to 5 years of experience in medical claims collection and be familiar with aging reports, delinquent claims reports, correspondence, EOBs, and other sources of information.
- Demonstrated ability to be detail oriented with strong aptitude for accuracy required
- Demonstrated ability to effectively work with others required
- Knowledge of proper business writing standards for letters and memos including the ability to write a correspondence with proper punctuation, grammar, spelling, etc
- Proven effective verbal, listening and written communications skills
