Medical Billing & Collection Specialist - Office Park - Business Office Admin

Overview

USA Health is Transforming Medicine along the Gulf Coast to care for the unique needs of our community.

USA Health is changing how medical care, education and research impact the health of people who live in Mobile and the surrounding area. Our team of doctors, advanced care providers, nurses, therapists and researchers provide the region's most advanced medicine at multiple facilities, campuses, clinics and classrooms. We offer patients convenient access to innovative treatments and advancements that improve the health and overall wellbeing of our community.

Responsibilities

Answers telephone and provides information on patient statements/correspondence with the appropriate follow-up; assists walk-in customers with questions regarding billing; fields complaints and disputes to the proper personnel; works encounter interrupts daily; works e-mail daily; reviews and monitors in-house encounters; works incoming correspondences; completes encounters in work queues weekly; sets contact terms on encounters, which meet minimum payment requirements; follows up on delinquent formal payment plans; prepares encounters for audits and documents and charges with results of audit; researches self-pay encounters for insurance coverage and forwards information to proper area for encounter update; prepares encounters for recommendation of refund; verifies employment and checks probate court for property and estate claims; reviews discharged patients for correctness of patient and insurance information and necessary forms; recommends encounters for suit or placement with an outside collection agency or attorney; reviews Mobile County Record for court action involving patient encounters; submits encounters for estate filing; maintains a thorough and current knowledge of billing requirements and reimbursement methodology for all assigned coverages; maintains reports and lists as required by management; collects and reconciles encounters for assigned coverage; responds timely and accurately to written billing inquiries from patients and/or insurance companies; makes necessary demographic and insurance additions, deletions, and changes to the system guarantor/patient information; utilizes online systems for follow-up and reconciliation of encounters; works audit reports received from insurance companies; maintains encounter integrity by ensuring that insurance pro-ration, adjustments and transactions are accurate; reconciles encounters from insurance Explanation of Benefits; monitors insurance payments and allowances for proper reimbursement per contract; reconciles credit balances; checks work items and email daily and takes appropriate action; identifies solutions to work related problems and issues; requests medical records as needed and follows up on receipt of same; communicates and uses appropriate customer relations skills with physicians, patients, families and USA personnel in person and via telephone; communicates work-related problems and issues to supervisor or management staff; maintains accurate and complete records by documenting all follow-up activities with insurance company or patient clearly and concisely on the patient encounter; maintains proper filing of patient and insurance correspondence to include Explanation of Benefits and insurance denials; maintains contact file folder on all patients with established contract terms; adheres to hospital policies including confidentiality; regular and prompt attendance; ability to work schedule as defined and overtime as required; related duties as required.

Qualifications

High school diploma or equivalent and one year of medical billing and/or collections experience in a medical office setting.

Hospital billing and claim follow-up experience relating to commercial, UHC and Medicare Advantage plans is highly preferred.