Billing & Collections Officer

Description

Job Summary

Without our billing and collecting officers (BCO), LA CENTA would not survive. These officers are responsible for managing and processing all claims, payments and monthly statements along with any and all other responsibilities set forth by the billing department. BCO should be proficient in ICD9/10 and CPT coding especially as pertains to Otolaryngology, Allergy, and Facial Plastic Surgery. They report first to the BCO department manager and then the office manager. BCO will often also meet directly with the Physician for monthly reports.

Job Duties and Responsibilities

• Perform charge entry using billing system coding tools.
• Collect time of service payments, reconcile and deposit time of service monies.
• Work end of day administrative billing tasks.
• Correct claims held by global rules and worked denied claims.
• Ensure that NPI and payer specific numbers are maintained in the billing system.
• Ensure individual providers are set up in the EHR system for individual billing and review provider enrollment status as needed.
• Ensure that fee schedules are updated as needed.
• View billing summary and patient activity daily.
• Manage collections and create suitable payment plans.
• Post adjustments in the billing system and transfer balances if appropriate using correct “kick” codes.
• Utilize the “statement” administration tools to create and run self-pay account worklists.
• Run payment mismatch reports in the billing system and perform zero-pay review.
• Use advanced billing worklists to search for payments by check number, track billing batches, generate a worklist and adjust claims.
• Post unapplied credits to outstanding balances.
• Track actions on overpaid claims, post and process insurance refunds.
• Create report on the billing system that summarize non-billable procedures and procedures requiring coding review.
• Ensure that authorizations for any and all treatments have been received.
• Keep Office Manager updated on any billing issues that require her knowledge and assistance.
• Respond to any and all correspondence pertaining to outstanding insurance issues.
• Ensure that all charges are appropriate so that the allowed amount corresponds to the charged amount.
• Perform other duties as assigned.

Requirements

Qualifications and Experience

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are reflective of the knowledge, skill, and/or ability required.

• Graduate of a medical billing program.
• 2-3 years of experience as an insurance biller or claims examiner in the medical insurance industry.
• Proficiency in ICD 9/10 coding for: Otolaryngology, Allergy, and Facial Plastic Surgery
• Comprehensive knowledge of electronic billing systems, preferably Advanced MD
• Knowledge of medical billing concepts and medical terminology.
• Knowledge and understanding of the relationship between procedure and diagnosis compatibility to maximum reimbursement.
• Excellent communication skills with patients, physicians, and staff
• Excellent organizational, interpersonal and decision-making skills
• Ability to work in a relatively unsupervised environment with a high degree of accuracy

Physical Demands

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. Individual will be required to:

• Sit for long periods at a time
• Use hands and fingers in repetitive motions, daily
• Ability to lift, push, pull up to 10 lbs. periodically
• Travel to clinic locations or sites as needed
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions