CPC Medical Billing Specialist

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$500.00

POSITION SUMMARY

Responsible for performing all tasks related to the Billing, Follow-up and Collections functions for CPa Medical Billing.

ESSENTIAL FUNCTIONS & RESPONSIBILITIES

1. Research all information needed to complete billing processing
2. Post any corrections to claims to ensure integrity of account information.
3. Review billing reports to ensure proper billing procedures are followed based on federal and state rules and regulations.
4. Research and resolve all Third-party collection related activities, including working through accounts receivables to maximize reimbursement.
5. Function as a liaison between patients and site staff on claims, billing questions or insurance related issues as directed by management
6. Research Overpayments, record adjustments to account and determine the appropriate destination of unidentified funds.
7. Respond to inquiries from outside agencies, insurance companies to assist in claim payment processing.
8. Effectively process all patient and third-party correspondence, including requests for copies of claims, statements and initiate refunds.
9. Process all legal documentation as it relates to patient accounts.
10. Act as a resource for CPa Staff and patients regarding health insurance claim policies, procedures and requirements.
11. Provide support to the CPa management team on various areas of patient billing research and analysis.
12. Work on various projects as assigned by the Billing Department Management Team.
13. Research, trouble-shoot Accounts Receivable reports and rejections, process appeals where appropriate, and make recommendation for write offs.
14. Is responsible for accurate and timely completion of job assignments.

ADDITIONAL GENERAL REQUIREMENTS

Professional positive attitude, vision, understanding of customer service principals, trustworthiness, and excellent interpersonal skills to successfully accomplish tasks necessary to meet high standards of ethical and social responsibility required by this position.

JOB QUALIFICATIONS/REQUIREMENTS

EDUCATION: High School Diploma. Knowledge of Medical Billing and Procedures.

EXPERIENCE:

• Certified Professional Coder Certificate a MUST
• Minimum 3 years experience in a medical office environment.
• Experience with Windows applications, proficient use of computer, Microsoft Word and Microsoft Excel.
• Strong communication, verbal and written and interpersonal skills. Ability to analyze and solve problems with limited assistance. Ability to maintain confidentiality.
• Knowledge and use of the English language, Bi-lingual a Plus
• Basic math skills
• Critical thinking, analytical and problem-solving skills

STANDARD REQUIREMENTS

• Supports an ethical standard which complies with a code of conduct free of conflicts of interest.
• Supports the Mission and Values of CPa.
• Supports, cooperates with, and implements specific procedures and programs for:
  • Safety, including universal precautions and safe work practices, established fire/safety/disaster plans, risk management, and security, report and/or correct unsafe working conditions, equipment repair and maintenance needs.
  • Confidentiality of all data, including patient, employee and operations data.
  • Quality Assurance and compliance with all regulatory requirements.
  • Compliance with current law and policy to provide a work environment free from sexual harassment and all illegal and discriminatory behavior.

• Supports and participates in common teamwork:
• Cooperates and works together with all co-workers; plan and complete job duties with minimal supervisory direction, including appropriate judgment.
• Uses tactful, appropriate communications in sensitive situations.
• Follows up as appropriate with supervisor and co-workers regarding reported complaints, problems and concerns.
• Promotes positive public relations with patients, physicians and site staff.

EQUIPMENT / MACHINES USED IN THE PERFORMANCE OF THIS JOB

Excellent PC skills including knowledge of Microsoft Office, Internet and database management tools.

PHYSICAL DEMANDS

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Performing the duties of this job requires sitting or standing for long periods of time. Occasional bending, stretching or lifting. Ability to hear normal range of voice. Ability to prepare written reports and use telephone equipment.

WORK ENVIRONMENT

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. As a representative of CPa Medical Billing, incumbent must conduct himself/herself at all times in a professional, positive, respectful, and supportive manner.