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Billing Specialist

Company: Women's Care Florida
Location: Beverly Hills
Posted on: November 13, 2021

Job Description:

Billing/Revenue CyclePosted Date. 1 month ago(9/17/2021 10:24 AM). Job ID. 2021-5944. # of Openings. 1. Category. Overview. The Insurance Verification/ Billing Specialist performs verification of insurance benefits and will request authorizations for patient with Infertility coverage. Will assist with clerical functions for the Insurance billing department, and will assist with resolution of problems to ensure a clean billing process. Will assist Billers with patient billing entries, patient calls as needed. Works with others in a team environment.. Responsibilities. Job responsibilities include but are not limited to:. Uses the insurance verification systems to contact the patient and their partner's insurance to verify benefits, identify benefit maximums, and coordination of benefits.. Enters information obtained through such contact into the patient and their portal prior to the patient's first appointment.. Advises if it is determined that a patient's benefits do not cover infertility treatment and that they will be in a Self-Pay status, if they wish to receive treatment. Also, inactivates the patient and their partner's insurance in the billing system, if it is determined that they have no insurance benefits.. Assists in the maintenance of the patient and their partner's account by obtaining, accurately recording, and updating personal and financial information as required.. Ensures all insurance requirements are met, secures payer authorizations with insurance for required services in an expeditious manner, and ensures that all documentation is entered according to division workflow to facilitate information sharing with all staff.. Documents progress of requests and follow up in information systems until requirement is satisfied and treatment can be approved.. Enter authorization or precertification information into multiple systems in appropriate location.. Green light approved treatment cycles in a timely manner.. Extend expired authorizations when treatment has been delayed.. Identify any need for peer-to-peer, letter of medical necessity or other documentation to obtain treatment precertification and notify provider immediately.. Serves as insurance benefits resource to PCC and medical office staff during treatment.. Maintains confidentiality of patient information and account status.. Maintains knowledge of and complies with external healthcare industry policies and procedures, including government, insurance, and third-party-payer regulations.. Monitors Insurance Benefits Verification Representative's processing of assigned daily activities and partners with the Billing Manager to advise of necessary adjustments to work flow, when indicated, to assure ultimate reimbursement and patient satisfaction scores.. Identifies and implements opportunities for work redesign/cross-training of procedures that improve the quality and quantity of work processed by Benefits and Authorization Coordinator. Primary point of contact with office managers when escalated requests or scenarios occur regarding the verification process.. Contributes to team effort by maintaining an excellent rapport and working relationship with patients, insurance company contacts, nursing staff, office staff, and CEO as needed; cooperating with other departments within the organization.. Maintains confidentiality of patient information and account status.. Maintains knowledge of and complies with external healthcare industry policies and procedures, including government, insurance, and third-party-payer regulations.. Obtaining referrals and pre-authorizations as required for procedures.. Checking eligibility and benefits verification for treatments, hospitalizations, and procedures.. Will process patients credit card payments and Insurance credit payment. Will post to the patients accounts.. Identifying and billing secondary or tertiary insurances.. Will reconcile all credit card charges in Card pointe and provide to accounting.. Answering all patient or insurance telephone inquiries pertaining to assigned accounts with the best customer service communication tactic.. Other job related duties as assigned. Knowledge Skill and Ability:. Ability to comprehend and explain Insurance benefits and coverage of services, which also includes co-payment amounts, deductible amounts, coverage percentages, insurance premiums.. The Insurance Verification Specialist will have a working knowledge of insurances.. Responsible for understanding and communicating medical information, identifying potential issues, collecting and documenting/ publishing data, establishing facts, drawing conclusions, and solving problems are essential.. Knowledge of insurance guidelines and regulations.. Competent use of computer systems, software, and 10 key calculators.. Familiarity with CPT and ICD-10 Coding.. Excellent communication abilities for phone contacts with insurance payers to resolve issues.. Excellent Customer service skills for interacting with patients regarding medical claims and payments, including communicating with patients and family members of diverse ages and backgrounds.. Ability to work well in a team environment. Being able to triage priorities, delegate tasks if needed, and handle conflict in a reasonable fashion.. Problem-solving skills to research and resolve issues in a calm manner and patience working with either patients or insurances during this process.. Infertility and/or Gynecological Experience Preferred. Maintaining patient confidentiality as per the Health Insurance Portability and Accountability Act of 1996 (HIPPA).. Ability to multitask.. Qualifications. Minimum Qualifications. High School graduate or equivalent and two (2) years of medical insurance/benefits verifications, and experience with requesting Insurance Authorizations. Some experience with Billing functions. Desired Qualifications. Bachelor degree preferred or a combination of training and experience.. Work Conditions. 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.. Requires working under stressful conditions or working irregular hours.. Requires exposure to communicable diseases or body fluids.. Requires flexibility in changing patient census. Requires patience, compassion, and the ability to work successfully with a variety of patients, families and employee staff with positive results. May require critical thinking skills and the ability to work successfully independently or in a team. Requires the ability to adapt to, and follow established protocols and adjusting requirements. Noise level in the work environment is usually moderate.. Physical Requirmants:. 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. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.. While performing the duties of this job, the employee is frequently required to sit. The employee occasionally is required to stand, walk, use hands to finger, handle or feel, reach with hands and arms, stoop, kneel, crouch or crawl, climb or balance, talk and hear.. While performing the duties of this job, the employee is occasionally required to lift or exert force up to 15 pounds.. T. Employee Statement. ____ I have read and understand the job description for my position. I am able to perform all of the essential functions for this position.. ____ I agree to comply with the Corporate Compliance Policy and all laws, regulations and standards of conduct relating to my position. As an employee, I understand my duty to report any suspect violations of the law or the standards of conduct to my immediate supervisor, or Human Resources.. ____________________________________________. Employee Name (print). ______________________________________________ ________________________. Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.

Keywords: Women's Care Florida, Beverly Hills , Billing Specialist, Accounting, Auditing , Beverly Hills, California

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