Medical Billing Specialist

Job Description:

Job Title: Medical Billing Specialist

Department: Billing & Collections

Overtime Status: Non-Exempt

Position reports to: Director of Revenue Cycle

Location of position: Wichita, KS

Position Summary:

The Medical Billing Specialist works in completion of billing department tasks, including, but not limited to, using coded data to produce and submit claims, working directly with insurance companies, healthcare providers, and patients to process claims, reviewing and appealing unpaid and denied claims, answering patient billing questions, and handling collections on unpaid accounts.May perform other duties as assigned or requested.

Responsibilities:

• Post patient and insurance payments (including electronic posting)
• Work primary and secondary claim denials
• File Medicare appeals and redeterminations
• Process accounts for collections
• Prepare refunds
• Perform end-of-day process
• Answer phone calls and assists patients with questions
• Obtaining authorization and referrals for surgeries (elective and urgent) and procedures
• Prepare patient letters with billing estimates
• Follow-up on surgery payments
• Prescription Pre-authorization
• Work insurance follow-up and updates
• Process overpayments for recoupment or refund
• Statement processing
• Policy updates
• Communicating pertinent policy updates to staff
• Other duties as requested and assigned
  

Qualifications:

• High school diploma; some college preferred

Physical Requirements:

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.

• Skill in appropriate documentation and records maintenance.
• Skill in usage of PC, multi-line phone, copier, fax, and printer.
• Ability to interpret, adapt and apply written guidelines and procedures to standard work practice.
• Ability to speak effectively before individuals and/or groups.
• Able to hear average or normal conversations and receive ordinary information.
• Movements frequently and regularly required using the wrists, hands, and/or fingers.
• Using primarily just the fingers to make small movements such as typing, picking up small objects, or pinching fingers together.
• Average, ordinary, visual acuity necessary to prepare or inspect documents or products, or operate machinery.
• Prolonged periods of sitting, standing or walking may be required, should be able to transport approximately 0-25lbs of charts or files.
  

Working Conditions:

• Fast paced clinical office environment
• Contact with Physicians, staff, patients, outside medical practices and insurance companies