Billing Representative - Integrations

POSITION SUMMARY: The Billing Representative will process claims and post various types of payments to patient accounts in an accurate manner that is legal, professional, timely and within the guidelines of the company, Medicare, Medicaid and all third-party payors. 

Location: Wabash, IN

This role is an on-site position.  

Wage will be dertermined based on knowledge, skills, ability and previous experience.  

ESSENTIAL RESPONSIBILITIES:

• Demonstrate and uphold the mission statement and values of Bridgeview Eye Partners.


• Review and process medical insurance claims.


• Resolve insurance billing related issues with insurance companies in regard to facility and physician billing.


• Correct and re-bill insurance claims for payment per the billing guidelines of the payor.


• Resolve coding and claim discrepancies with insurance companies.


• Expedite payment from Medicare, Medicaid and third-party payors to reduce accounts receivable aging.


• Respond to denied claims quickly and efficiently to ensure prompt payment.


• Process patient statements and collections.


• Process patient and insurance refunds.


• Post payments from insurance payors as well as patient statements.


• Assist with billing/payment questions from staff/patients at location, by being a resource for insurance coverage and general insurance related questions.


• Communicate issues to Manager along suggested solutions to improve.


• Assist with the education of the office staff to improve collections performance.


• Perform any other related duties as assigned by the Supervisor.

OTHER RESPONSIBILITIES:

• Demonstrate knowledge of the content and context of billing forms and documents such as insurance remittances and CMS 1500 forms.


• Maintain strong working knowledge of Medicare, Medicaid and third-party coding, billing and collection policies, procedures and laws.


• Demonstrate a strong working knowledge of CPT and ICD-10 codes and competency regarding procedural, diagnosis and HCPC coding.


• Demonstrate knowledge of insurance companies’ guidelines for claims preparation, billing and collections.


• Demonstrate a strong working knowledge of an electronic health record system and claims clearinghouse software.


• Work with ten-key calculators, computers and practice management software in a competent manner.


• Protect Bridgeview Eye Partners and its assets by following all billing and compliance guidelines, rules and regulations and never knowingly committing a fraudulent act.


• Protect and maintain confidentiality of sensitive PHI and company information .

EDUCATION AND/OR EXPERIENCE:  

• A minimum of two (2) years of experience in patient services and or Medicare/Medical billing preferred.


• Experience in Optometry/Ophthalmology billing preferred.

COMPETENCIES:

• communication skills


• attention to detail


• adaptability


• customer service oriented


• problem solving skills


• integrity


• confidentiality


• decision-making skills


• adaptable to change


• professional composure

PHYSICAL DEMANDS AND WORK ENVIRONMENT (per ADA guidelines):

• Physical Activity: Talking, Hearing, Repetitive motion.


• Physical Requirements: Sedentary work. Involves sitting most of the time.


• The worker is required to have visual acuity to determine the accuracy, neatness, and thoroughness of the work assigned.

PERSONAL DEVELOPMENT:

• Demonstrate and maintain technical knowledge of the job and of related procedures and policies in order to provide high quality support to the department. This may involve participation in advanced training and/or certification in field as appropriate.

In addition to the expectations listed above, each employee must demonstrate a commitment to the organization’s Values, Standards of Conduct,  and Standards of Care.