Patient Accounts Billing Specialist (Part Time)

Vernon Hills, IL
$22.00-24.00 per hour
Permanent
Part-time

2 months ago
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The Patient Accounts Billing Specialist is responsible for verifying patient insurance coverage, interpreting benefits plans, processing patient procedure estimators, deductibles and co-insurance balances, performing prior-authorizations and pre-determinations for patient services, and ensuring accurate billing practices by thoroughly understanding the details of various health insurance policies to maximize revenue collection for our healthcare providers, all while adhering to compliance regulations. Effective and efficient communications with insurance payors, providers and patients is paramount for success in this role. The Specialist is also to support the Revenue Cycle Manager in assisting with all patient financial transaction matters including revenue cycle; deposit/pre-payments made via cash or credit card; service episode payments made via cash or credit card; insurance payments; and, where applicable, refund payments and balance due follow-up activities. Where applicable, this individual will identify process/workflow improvement opportunities to ensure an ongoing state of compliance and actively assists in implementation, training, and follow-up by others. Duties must be executed in a manner that upholds the practice's standards of excellence and in accordance with Federal, State, company, and employee handbook policies and procedures.KNOWLEDGE, SKILL, & EXPERIENCE REQUIREMENTS

Bachelor's degree from an accredited four-year college or university OR equivalent combination of experience, education, and training that would provide the required knowledge and abilities
Knowledge of ICD-10-CM and CPT coding guidelines; medical terminology; anatomy and physiology; state and federal Medicare reimbursement guidelines
Three years or more of related experience required
Excellent written and verbal communication skills to prepare reports and related documents and to maintain working relationships with physicians and other staff
Excellent organizational and time management skills
Proficient in Microsoft Office Suite
Experience in Nextech PM and EMR, Trizetto and Klara are preferred but not required
Ability to work in an environment where multi-tasking is required
Ability to research and analyze data, draw conclusions, and resolve issues; read, interpret, and apply policies, procedures, laws, and regulations
Ability to read and interpret medical procedures and terminology
Ability to develop training materials, make group presentations, and to train staff
Ability to exercise independent judgment
Consistently maintains confidentiality on all patient accounts and business matters

RESPONSIBILITIESThe essential functions include, but are not limited to:PATIENT ACCOUNTS MANAGEMENT

Prepares financial responsibility/out of pocket estimates for patients. Documents and properly uses practice management software to ensure transparency with respect to financial responsibility obligations and transactions.
Intimately knows and employs our fee schedule relative to subscriber benefits to ensure accurate estimate generation
Makes good faith attempts to notify patients of estimated amounts as quickly as possible. Where appropriate, contacts patients/guarantors for payments and balances due.
Proactively monitors and reviews provider schedules for events such as add-on exams/procedures or schedule changes. Acts is a swift and decisive manner to ensure changes follow pre-authorization/pre-payment workflow and that we support the patient experience as best we can.
Manages Pre-certifications/Prior authorizations, initiating and coordinating with specialty pharmacies for treatment authorization and therapy deliveries
Actively participates in training, coaching, and mentoring others on the billing eligibility and estimator workflow to ensure alll teammates are well informed and meet best practice standards
Answers phone and electronic messages/needs in a timely, polite and respectful manner; works hard to ensure priorities are set and deadlines are accomplished at all times throughout the operating year
As needed, participates in the preparation of business activity reports

BILLING & CODING

Supports the efforts of the practice and Revenue Cycle Manager to manage accounts receivables; work externally to support claims concerns or issues; and ensures documentation for billing batches, EOBs, and outstanding claims are made in a timely manner
Participates in the insurance billing function of the business office, and sees to the proper application of patient, insurance, and other payments
Evaluates medical record documentation and charge-ticket coding to optimize reimbursement by ensuring that diagnostic and procedural codes and other documentation accurately reflects and supports outpatient visits and to ensure that data complies with legal standards and guidelines.
Interprets medical information such as diseases or symptoms and diagnostic descriptions and procedures to accurately assign and sequence the correct ICD-10-CM and CPT codes.
Reads bulletins, newsletters, and periodicals and attends workshops to stay abreast of issues, trends, and changes in laws and regulations governing medical record coding and documentation
Educates and advises staff on proper code selection, documentation, procedures, and requirements
Identifies training needs, prepares training materials, and conducts training for physicians and support staff to improve skills in the collection and coding of quality health data as it relates to procedure estimators

POLICY ADHERENCE

Adherence to company, Federal, State, locality-specific policies and procedures
Understand, abide, and enforce the Employee Handbook
Demonstrate adherence to dress code standards
Demonstrate adherence to life safety practices standards
Uphold strict confidentiality by abiding to HIPAA regulations and identity theft policies

We are a drug-free, equal-opportunity employer. Reference and background check required.

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