PURPOSE:  Supports practice revenue and patient satisfaction goals by filing insurance claims, monitoring patient accounts, taking remedial and preventive action to reduce rejected claims, securing payment on past due accounts, providing meaningful payment information to practice management.

EDUCATIONAL REQUIREMENTS:  Bachelor’s Degree or equivalent experience and CPC certification

EXPERIENCE:  Three years medical office billing/coding experience.

ACCOUNTABILITIES:

• Facilitates timely reimbursement by obtaining complete and accurate information needed for claims submission; determining primary and secondary carriers when necessary; reviewing EOBs and matching them to the appropriate claims; completing and filing paper and electronic claims on a daily basis; sending regular statements to patients with outstanding balances, etc.            
• Supports patient satisfaction goals by responding to patients' billing questions in a prompt and courteous manner; researching disputed account balances, correcting any errors (including misapplied payments and overpayments), reversing past due fees
• Supports sound practice decision making by regularly monitoring payments received, preparing patient accounts reports by payor  type and status of patient accounts (number of days past due, etc.); following practice guidelines to obtain additional information from patients/payors with past due accounts, etc.
• Reduces claims rejection rate by researching rejected claims, gathering additional documentation required, correcting any errors, verifying accuracy of corrected claim, and re-filing in a timely manner; suggesting improvements in practice procedures and/or forms that would result in fewer rejected claims.
• Secures outstanding patient balances by reviewing status of delinquent accounts, establishing payment arrangements with patients, notifying patients when decision has been made to turn their account over to a collection agency, an attorney, or to small claims court; preparing paperwork for claims against past due accounts; testifying for the practice in court cases; recording any judgments with the appropriate officer(s) of the court; reporting patients to the credit bureau(s).                               
• Ensures compliance with all Insurances carries (Medicare/Medicaid) requirements by staying up-to-date on billing requirements.
• Protects the reputation of the practice by adhering to professional standards for collections and accounting, practice patient confidentiality policies and collections procedures, and federal (FCRA, HIPAA, etc.), state, and local statutes.                                                                             
• Supports the maintenance of complete and accurate practice records by taking appropriate follow-up action on patient statements, etc. returned as undeliverable.                                                                       
• Contributes to team efforts by assisting other departments at the direction of her/his manager or team lead.
• Participate in educational and professional development activities consistent with business needs.
• Maintain strictest confidentiality of medical/company information, being  knowledgeable and following  all HIPAA Regulations
• Perform related work as required.